POSTTRANSFUSION HEPATITIS-C VIRUS-INFECTION IN CHILDREN

Hepatitis C virus (HCV) infection was investigated retrospectively and prospectively in children who had open heart surgery. The retrospecti ve study included 196 patients who had open heart surgery 2 to 6 years before enrollment and were regularly followed. Antibody to HCV was de tected in eight cases, and seven of these eight patients had viremia c aused by HCV infection. The other patient's anti-HCV titer gradually d ecreased and HCV ribonucleic acid was absent throughout the course. Fo ur of these eight had persistent viral replication without clinical ev idence of hepatitis; the other three had viremia and chronic hepatitis . The HCV infection rate in the retrospective study group was about 4% . The HCV was of genotype 2 in five cases and of genotype 3 in two cas es. The clinical outcome was not related to sex, age, amount of transf usion, or HCV genotype. For the prospective study, we enrolled 94 pati ents. Of the 56 enrolled after the initiation of anti-HCV screening in the blood bank, none was infected by HCV. Of the 94 patients, 38 were enrolled before screening; 4 had abnormal liver function 1 to 3 month s after operation, and 2 were infected with HCV, One patient had an ac ute but resolving course; the other had persistent anti-HCV and HCV vi remia, although the liver function test results returned to the normal range. The HCV in both cases belonged to genotype 2. We conclude that in Taiwan the seroconversion rate of HCV in children who underwent op en heart surgery was 4% to 5%. Anti-HCV screening in donor blood signi ficantly decreased the incidence of posttransfusion hepatitis C.