An epidemiological survey of hepatitis C virus infection in Italian children in the decade 1990-1999

Background: A retrospective-prospective survey of Italian children with hep atitis C virus (HCV) infection was planned in 1998 to explore the epidemiol ogic features of infection during the past decade. Methods: Anti-HCV-positive patients (or HCV RNA-positive infants) aged 1 mo nth to 16 years, consecutively observed in 20 pediatric Institutions, were considered. An anonymous epidemiologic questionnaire based on clinical reco rds was used. Results: From 1990 through March 1999, 606 patients were observed (296 boys , average age 5.8 years). Maternal infection (46% of cases) and blood trans fusions (34%) were the most frequent risk factors. Of 279 infected mothers, 61% did not recall a putative source of infection (by history, many could possibly have had exposure through routes such as therapeutic injections wi th nondisposable material), whereas 94 (34%) admitted drug abuse, including 49 (17%) coinfected with human immunodeficiency virus (HIV). Only 157 (26% ) children were born after 1991: 90% of their mothers were infected (11% we re HIV coinfected vs. 25% mothers of older children, P < 0.01). Conclusions: Maternal infection is a prominent source of pediatric HCV infe ction in Italy. The fact that most mothers had a history of covert exposure to HCV, probably through percutaneous routes that are no longer operating, and that the number of those with HIV coinfection has decreased suggests t hat the frequency of pediatric infection could decrease in the future.