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Changing epidemiologic pattern of chronic hepatitis C virus infection in Italian children
F Bortolotti1, M Resti, R Giacchino
1Clinica Medica 5, University of Padua, Italy.
Insights
Chronic hepatitis C virus (HCV) infection in children is often asymptomatic, increasing the importance of screening. Vertical transmission from mothers is the primary infection route, with maternal drug use a significant risk factor.
Area of Science:
- Pediatric infectious diseases
- Hepatology
- Epidemiology
Background:
- Chronic hepatitis C virus (HCV) infection presents diagnostic challenges in children.
- Asymptomatic cases are common, necessitating proactive screening strategies.
Purpose of the Study:
- To characterize the epidemiological features of chronic hepatitis C virus (HCV) infection in pediatric populations.
- To identify common exposure routes and risk factors for HCV infection in children.
Main Methods:
- A retrospective study of 106 children with chronic HCV infection across three Italian pediatric centers (1991-1997).
- Data collection focused on clinical presentation, exposure history, and maternal risk factors.
Main Results:
- Most children (86/106) were asymptomatic and diagnosed via screening.
- Vertical transmission was a major route, with 44% of children infected by HCV-positive mothers.
- Maternal intravenous drug use was a significant risk factor (36% of infected mothers).
Conclusions:
- HCV screening in children, particularly for at-risk populations, is crucial for diagnosis due to frequent asymptomatic presentation.
- Vertical transmission is the predominant route, highlighting the importance of maternal health and risk assessment.
- While maternal drug use is a key risk factor, a notable proportion of infected mothers lack identifiable risk factors, suggesting broader screening needs.
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.