Elsevier

The Journal of Pediatrics

Volume 133, Issue 3, September 1998, Pages 378-381
The Journal of Pediatrics

Changing epidemiologic pattern of chronic hepatitis C virus infection in Italian children☆,☆☆,★

https://doi.org/10.1016/S0022-3476(98)70273-2Get rights and content

Abstract

Objective: To evaluate the epidemiologic features of chronic hepatitis C virus (HCV) infection in children.

Study design: All 106 children with chronic HCV infection consecutively observed in 3 Italian pediatric centers between 1991 and 1997 entered the study.

Results: Fifteen children had a history of non-A, non-B hepatitis, and 5 complained of nonspecific symptoms. The 86 remaining patients were free of symptoms and were recruited after HCV screening for intercurrent diseases, maternal infection, or other putative exposure; 39% (none of 30 children born after 1990) had received transfusions, whereas 44%, had a mother with HCV infection. Of the 47 infected mothers, 36% were or had been intravenous drug users, 15% had received transfusions, and 45% had no history of exposure.

Conclusions: Children with chronic HCV infection are often free of symptoms, and thus HCV screening for putative risk has greatly increased the chances of diagnosis. Vertical transmission seems to now be the most common route of infection. Both current and past maternal intravenous drug abuse are risk factors for pediatric infection; however, in an area with relatively high prevalence of anti-HCV in the general population such as Italy, a consistent proportion of infectious mothers have no risk factors of HCV exposure. (J Pediatr 1998;133:378-81)

Section snippets

Patients

Between January 1991 and March 1997, 106 children (aged 9 months to 16 years) with chronic HCV infection were observed in 3 pediatric centers: the Pediatric Clinic in Florence (32 consecutive cases), the Department of Infectious Diseases Gaslini in Genoa (35 consecutive cases), and the Departments of Pediatrics and of Infectious Diseases of Padua Hospital (39 consecutive cases). None of these institutions was a referral center for selected liver diseases, and none had changed the referral

Results

At the time of enrollment, 15 children had a history of non-A, non-B hepatitis and had been followed up for 1 to 7 years, whereas 91 had only a 6-month history of anti-HCV positivity; 101 had alanine aminotransferase abnormalities, and 5 had persistently normal ALT levels (Table I). Thirty children were born after 1990.

Fifty-four percent of older children had received blood transfusions, administered in the perinatal period or early in life in 69% of cases. Conversely, none of the children born

Discussion

HCV infection is often asymptomatic in children, but in most cases fluctuating or intermittent ALT abnormalities can be found.14, 15 In the last few years screening for previous transfusions, for maternal infection during and after pregnancy, and for adoption have become powerful tools with which to identify children with chronic HCV.

Although we have not introduced a control group of patients matched for age and sex, the high prevalence of blood transfusions and of maternal infection in our

References (22)

  • L Romanò et al.

    Low prevalence of anti-HCV antibody among Italian children

    Infection

    (1994)

    • Cited by (0)

    ☆

    From Clinica Medica 5, University of Padua, Italy; Department of Pediatrics, University of Florence, Florence, Italy; Department of Infectious Diseases, Gaslini Institute, Genoa, Italy; Department of Infectious Diseases of Padua Hospital, Padua, Italy; and Department of Pediatrics, University of Padua, Padua, Italy.

    ☆☆

    Reprint requests: Flavia Bortolotti, MD, Clinica Medica 5, Dip. di Medicina Clinica e Sperimentale, Via Giustiniani 2, 35100 Padova, Italy.

    ★

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