Related Experiment Videos
The epidemiology of transfusion-associated hepatitis C in a children's hospital
Naomi L C Luban1, Camilla A Colvin, Parvathi Mohan
1Division of Laboratory Medicine and Pathology, Children's National Medical Center, Washington, DC 20010, USA. nluban@cnmc.org
Insights
A study found 1.6% of children transfused before 1992 had hepatitis C virus (HCV) infection. Early identification of this chronic HCV is crucial for effective treatment, especially for iatrogenically induced infections.
Area of Science:
- Hepatology
- Infectious Diseases
- Pediatrics
Background:
- Blood transfusions before 1992 posed a risk for hepatitis C virus (HCV) infection in children.
- A lookback study was conducted to determine HCV prevalence and acquisition risks in this pediatric population.
Purpose of the Study:
- To ascertain the prevalence of HCV infection among children who received blood transfusions between 1982 and 1992.
- To identify risk factors associated with HCV acquisition in transfused children.
Main Methods:
- A cohort of 5473 children receiving transfusions was identified; 2758 were tested for HCV antibodies.
- HCV infection was confirmed using enzyme immunoassay (EIA), recombinant immunoblot assay (RIBA), and HCV RNA detection via PCR.
- Viral persistence was monitored using serial PCR tests.
Main Results:
- Of the tested children, 1.6% (43/2758) had persistent HCV infection confirmed by RIBA and HCV RNA.
- 39 children were positive for HCV RNA, while 4 cleared the infection.
- A potential association between fresh whole blood transfusions and HCV acquisition was observed.
Conclusions:
- HCV infection in children is often asymptomatic, necessitating targeted testing for diagnosis.
- The study successfully identified 43 children with newly diagnosed HCV infections.
- Identifying individuals with iatrogenic HCV is critical as treatments for hepatitis C improve.
Background:
Children transfused with blood and blood products before 1992 are at risk for chronic hepatitis C virus (HCV) infection. To determine the prevalence of HCV infection and risks associated with acquisition of HCV, a single-institution lookback study was performed.
Study Design And Methods:
A total of 5473 infants and children who received transfusions between 1982 and 1992 were identified. A control population of 600 age-, sex-, race- and zip code-matched children who did not receive transfusions with the same exclusions provided background seroprevalence data. Patients were tested for antibodies to HCV, confirmed with second generation recombinant immunoblot assay (RIBA) and when appropriate quantitative and qualitative HCV RNA by reverse transcription polymerase chain reaction (PCR). Viral persistence was assessed by serial PCR determinations for HCV RNA.
Results:
Of the 5473 eligible patients, 4726 were locatable and 2758 were tested. Forty-three children (1.6%) were persistently anti-HCV enzyme immunoassay (EIA)-positive, confirmed by RIBA; 39 were positive for the presence of HCV RNA. Four cleared their virus as assessed by two negative HCV PCRs 6 months apart. There was a borderline higher number of children with HCV who received fresh whole blood than those who tested HCV-negative.
Conclusion:
Because HCV infection is generally asymptomatic, children are not identified unless they are specifically tested. We identified, enrolled, tested, and confirmed a new diagnosis of HCV infection in 43 patients. As HCV treatments become increasingly effective, it is important to identify silently infected individuals, particularly when the infection was iatrogenically induced.
Related Concept Videos
01:25Hepatitis
01:28Viral Hepatitis I: Introduction
01:27Cytomegalovirus Disease
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism