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Posttransfusion hepatitis C virus infection in children
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Republic of China.
Insights
Hepatitis C virus (HCV) infection occurred in 4-5% of children undergoing open heart surgery. Blood screening significantly reduced post-transfusion hepatitis C incidence in pediatric patients.
Area of Science:
- Hepatology
- Virology
- Pediatric Surgery
Background:
- Hepatitis C virus (HCV) poses a risk to pediatric patients undergoing open heart surgery, primarily through blood transfusions.
- Understanding the incidence and risk factors for HCV infection in this vulnerable population is crucial for prevention.
Purpose of the Study:
- To determine the incidence of HCV infection in children who underwent open heart surgery.
- To evaluate the impact of anti-HCV screening in blood banks on preventing post-transfusion hepatitis C.
Main Methods:
- Retrospective analysis of 196 patients who had open heart surgery 2-6 years prior.
- Prospective enrollment of 94 patients, comparing those screened before and after blood bank HCV screening implementation.
- HCV antibody and RNA testing, viral genotyping, and liver function tests were performed.
Main Results:
- The overall HCV infection rate was 4% in the retrospective group (7/196).
- In the prospective group, none of the 56 patients screened after blood bank HCV implementation were infected.
- Of 38 patients screened before implementation, 2 (5.3%) were infected with HCV genotype 2.
Conclusions:
- The seroconversion rate for HCV in children undergoing open heart surgery in Taiwan is estimated at 4-5%.
- Implementing anti-HCV screening in donor blood significantly reduces the incidence of post-transfusion hepatitis C in pediatric surgical patients.
- HCV infection outcomes were not associated with sex, age, transfusion volume, or HCV genotype.
Abstract:
Hepatitis C virus (HCV) infection was investigated retrospectively and prospectively in children who had open heart surgery. The retrospective study included 196 patients who had open heart surgery 2 to 6 years before enrollment and were regularly followed. Antibody to HCV was detected in eight cases, and seven of these eight patients had viremia caused by HCV infection. The other patient's anti-HCV titer gradually decreased and HCV ribonucleic acid was absent throughout the course. Four of these eight had persistent viral replication without clinical evidence of hepatitis; the other three had viremia and chronic hepatitis. The HCV infection rate in the retrospective study group was about 4%. The HCV was of genotype 2 in five cases and of genotype 3 in two cases. The clinical outcome was not related to sex, age, amount of transfusion, or HCV genotype. For the prospective study, we enrolled 94 patients. Of the 56 enrolled after the initiation of anti-HCV screening in the blood bank, none was infected by HCV. Of the 94 patients, 38 were enrolled before screening; 4 had abnormal liver function 1 to 3 months after operation, and 2 were infected with HCV. One patient had an acute but resolving course; the other had persistent anti-HCV and HCV viremia, although the liver function test results returned to the normal range. The HCV in both cases belonged to genotype 2. We conclude that in Taiwan the seroconversion rate of HCV in children who underwent open heart surgery was 4% to 5%. Anti-HCV screening in donor blood significantly decreased the incidence of posttransfusion hepatitis C.