Article
Active surveillance of hepatitis C infection in the UK and
Ireland
D M Gibba, P E Neavea, P A Tookeya, M Ramsayb, H Harrisb, K Balogunb, D Goldbergc, G Mieli-Verganid, D Kellye
a Department of
Epidemiology and Public Health, Institute of Child Health, London, UK, b Immunisation Department, Communicable Disease
Surveillance Centre, London, UK, c Scottish Centre for Infection
and Environmental Health, Scotland, UK, d Paediatric
Liver Service, King's College Hospital, London, UK, e Liver Unit, Birmingham Children's
Hospital, Birmingham, UK
Correspondence to: Dr D M Gibb, Medical Research Council Clinical Trials Unit, 222 Euston Road, London NW1 2DA, UK email: d.gibb{at}ctu.mrc.ac.uk
Accepted 6 October
1999
AIM
To investigate the
prevalence, distribution, and clinical details of paediatric hepatitis
C virus (HCV) infection in the UK and Ireland.
METHODSActive monthly
surveillance questionnaire study coordinated through the British
Paediatric Surveillance Unit, to all consultant paediatricians in 1997 and 1998.
RESULTSA total of 182 HCV infected children were reported from 54 centres and by
paediatricians from eight different specialties. In 40 children HCV was
acquired through mother to child transmission (MTC children); 142 were
infected by contaminated blood products (n = 134), organ
transplantation (n = 2), needles (n = 4), or unknown risk factor
(n = 2). Intravenous drug use was the risk factor for 35 mothers of
MTC children. Twelve children were coinfected with HIV and four with
HBV. Recent serum aspartate aminotransferase or alanine
aminotransferase values were at least twofold greater than the upper
limit of normal in 24 of 152 children; this occurred in five of 11 HIV
coinfected children. Liver histology, available in 53 children, showed
normal (7%), mild (74%), moderate (17%), or severe (2%) hepatitis.
Twenty eight children had received therapy with interferon alfa.
CONCLUSIONMost
current paediatric HCV infection in UK and Ireland has been acquired
from contaminated blood products, and most children are asymptomatic.
There is a need for multicentre trials to inform clinical practice and
development of good practice guidelines in this area. Long term follow
up of this cohort of HCV infected children is planned to help determine
the natural history over the long term of HCV acquired during infancy
and childhood.
Keywords: hepatitis C infection; surveillance; natural history; UK and Ireland
© 2000 by Archives of Disease in Childhood
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