HEPATITIS-C SEROPOSITIVITY IN HIV-NEGATIVE CHILDREN WITH SEVERE HEMOPHILIA

With the advent of new viral inactivation and purification methods for factor concentrates in the 1980s, transmission of both HIV-1 and hepa titis viruses has been significantly decreased. However, on routine an nual testing of the paediatric population at the New England Hemophili a Center (NEHC), several children were noted to be hepatitis C (HCV) s eropositive. Thus, a retrospective review of children with severe haem ophilia was undertaken. Twenty-six children (median age: 7.5 years) un der the age of 12 were identified. All were HIV-1 seronegative and had received hepatitis B immunization. Of these, 22 had received factor c oncentrate. Four children had no documented HCV serostatus, and seven were HCV seropositive using a second-generation ELISA. Transfusion pro ducts were reviewed and stored serum samples were evaluated using a se cond-generation ELISA to identify the approximate date of seroconversi on with positive tests confirmed by RIBA analysis. Three children beca me seropositive before 1989 using factor concentrates with early viral attenuation procedures. Two children who seroconverted after 1991 rec eived only monoclonal affinity purified factor concentrate that was ei ther pasteurized or solvent/detergent treated. There was no evidence o f horizontal or nosocomial viral transmission. We are unable to prove causality with the factor concentrates used by these children. Continu ed surveillance with sensitive measures for detection of HCV in person s with haemophilia using plasma-derived factor concentrate is necessar y.