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

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 NCV 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 Ilo risk factors of HCV exposure.