PREVALENCE AND MANIFESTATIONS OF HEPATITIS-C SEROPOSITIVITY IN CHILDREN IN AN ENDEMIC AREA

Background. According to our previous studies, Paisha Township in Peng hu Islets is an endemic area for hepatitis B virus and hepatitis C vir us (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-H CV-positive children, Methods. In March, 1994, 1164 (93.6%) of 1243 st udents from all 6 kindergartens, 9 primary schools and 3 middle school s in Paisha Township participated in the screening for anti-HCV by enz yme immunoassay with second generation commercial kits (Abbott EIA 2.0 ). Anti-HCV tests were duplicated for the positive sera in 2 laborator ies. 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 31 8), 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 i n the other 5 cases, None had sonographic parenchymal changes in the l iver. 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 th an 2.0; 2 of them had 2 elevations of alanine transaminase values. Fou r 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. Conclusion. Only 36% (4 of 11) of anti-HCV-positive children had an O D of >2.0. Subjects with sequentially low OD might recover from chroni c HCV infection without detectable HCV RNA and with normal alanine ami notransferase values.