England K., Thorne C., Harris H., Ramsay M., Newell M.-L.
MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom; Immunisation Department, Centre for Infections, Health Protection Agency, London, United Kingdom; Africa Centre for Health and Population Studies, University of KwaZulu Natal, Mtubatuba, South Africa
England, K., MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom; Thorne, C., MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom; Harris, H., Immunisation Department, Centre for Infections, Health Protection Agency, London, United Kingdom; Ramsay, M., Immunisation Department, Centre for Infections, Health Protection Agency, London, United Kingdom; Newell, M.-L., MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom, Africa Centre for Health and Population Studies, University of KwaZulu Natal, Mtubatuba, South Africa
Despite the introduction of blood donor screening, worldwide, children continue to become infected with hepatitis C virus (HCV) via un-sterile medical injections, receipt of unscreened blood and isolated hospital contamination outbreaks. It is plausible that the natural history and disease progression in these children might differ from that of their vertically infected counterparts. Vertically and parenterally HCV-infected children were prospectively followed within the European Paediatric HCV Network and the UK National HCV Register, respectively. Biological profiles were compared. Vertically and parenterally HCV-infected children differed in terms of some key characteristics including the male to female ratio and the proportion of children receiving therapy. Parenterally infected children were more likely to have at least one hepatomegaly event during follow-up, 20%vs 10%. Parenteral infection did not significantly affect the odds of being consistently viraemic (AOR 1.14, P = 0.703) and there was no significant difference in the odds of having consistently elevated ALT levels and mode of acquisition (AOR 0.83, P = 0.748). The proportion of children with 2 or more markers of HCV infection did not differ significantly by mode of acquisition (χ 2 1.13, P = 0.288). This analysis does not support substantial differences between vertically and parenterally infected groups, but there are specific mechanisms identified requiring further investigation. Given the continued parenteral infection of children worldwide, it is vital that knowledge of disease progression in this group is accurate and that the differences in comparison with vertically infected children are clarified to inform more accurate and individualized clinical management. © 2011 Blackwell Publishing Ltd.
alanine aminotransferase; biological marker; accuracy; alanine aminotransferase blood level; article; blood donor; child; disease course; epidemic; female; follow up; hepatitis C; hepatomegaly; human; major clinical study; male; priority journal; prospective study; vertical transmission; viral contamination; viremia; Adolescent; Alanine Transaminase; Biological Markers; Child; Child, Preschool; Disease Progression; Female; Follow-Up Studies; Genotype; Hepacivirus; Hepatitis C; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Interferon-alpha; Logistic Models; Male; RNA, Viral; Sex Ratio; Viremia
