Hepatitis C infection in children and adolescents with end-stage renal disease.
The prevalence of hepatitis C virus (HCV) infection and the risk factors associated with its transmission are described in a contemporary cohort of 55 children and adolescents with end-stage renal disease (ESRD). Thirty-seven patients were on dialysis or had been transplanted (ESRD) and 18 had chronic renal failure (CRF) but had not yet received dialysis. Seven (19%) tested positive for HCV by enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR), or both. None of the children with CRF were infected. HCV infection was associated with length of time on dialysis, but not with age, gender, race, or units of blood transfused. These data corroborate earlier reports and confirm that children with ESRD continue to have a high prevalence of HCV. It is also shown for the first time that elevated transaminases should not be employed to predict HCV infection in this cohort, as all affected children had normal serum levels. Because of unique characteristics in this cohort, both ELISA and PCR are required to maximize HCV diagnostic sensitivity. Although HCV remains an important consideration in pediatric ESRD, the present study shows that recent advances in clinical practice have eliminated one of the major ways in which it was previously being transmitted.
Molle
Zarela L
ZL
Division of Pediatric Gastroenterology and Nutrition, SUNY Health Science Center at Brooklyn, New York 11201, USA.
Baqi
Noosha
N
Gretch
David
D
Hidalgo
Guillermo
G
Tejani
Amir
A
Rabinowitz
Simon S
SS
D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy / Q000821:virology*; D008297:Male; D009518:New York / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D013997:Time Factors; D000637:Transaminases / Q000097:blood
D000637:Transaminases