Prevalence and manifestations of hepatitis C seropositivity in children in an endemic area.
BACKGROUND
According to our previous studies, Paisha Township in Penghu Islets is an endemic area for hepatitis B virus and hepatitis C virus (HCV) infection and for hepatocellular carcinoma. We conducted this study to understand the prevalence of anti-HCV seropositivity among children in this area and to observe clinical manifestations of anti-HCV-positive children.


METHODS
In March, 1994, 1164 (93.6%) of 1243 students from all 6 kindergartens, 9 primary schools and 3 middle schools in Paisha Township participated in the screening for anti-HCV by enzyme immunoassay with second generation commercial kits (Abbott EIA 2.0). Anti-HCV tests were duplicated for the positive sera in 2 laboratories. All anti-HCV-positive children were followed annually for 2 years.


RESULTS
The prevalences of children from kindergartens (ages 3 to 6 years), primary schools (ages 7 to 12 years) and middle schools (ages 13 to 15 years) were 0% (0 of 229), 0.8% (5 of 617) and 1.9% (6 of 318), respectively. Initially the optic density (OD) values of anti-HCV were > 2.0 in 4 cases (36%), between 1.0 and 2.0 in 2 cases, and < 1.0 in the other 5 cases. None had sonographic parenchymal changes in the liver. In the 2-year follow-up of the anti-HCV-positive subjects, type 2a HCV-RNA persisted in 3 of 4 children with an OD of anti-HCV more than 2.0; 2 of them had 2 elevations of alanine transaminase values. Four of 7 children with an OD of 2.0 or less had a decrease in OD values in the follow-up examinations, and 2 of them became anti-HCV-negative.


CONCLUSIONS
Only 36% (4 of 11) of anti-HCV-positive children had an OD of > 2.0. Subjects with sequentially low OD might recover from chronic HCV infection without detectable HCV RNA and with normal alanine aminotransferase values.
Lu
S N
SN
Department of Internal Medicine, Kaohsiung Chang-Gung Memorial Hospital, Taiwan.
Chen
H C
HC
Tang
C M
CM
Wu
M H
MH
Yu
M L
ML
Chuang
W L
WL
Lu
C F
CF
Chang
W Y
WY
Chen
C J
CJ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016174:Hepacivirus / Q000302:isolation & purification*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology; D018936:Hepatitis C Antigens / Q000032:analysis; D006801:Humans; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013624:Taiwan / Q000453:epidemiology
D006514:Hepatitis B Surface Antigens; D018936:Hepatitis C Antigens; D012367:RNA, Viral