Department of Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
Trans R Soc Trop Med Hyg. 2010 May;104(5):357-63. doi: 10.1016/j.trstmh.2010.01.009. Epub 2010 Feb 12.
A prospective study in three Egyptian villages (A, B and C) having a high prevalence of hepatitis C virus (HCV) infection examined incidence of community-acquired HCV infection in children; 2852 uninfected infants were prospectively followed from birth for up to 5.5 years. Fifteen seroconverted for either HCV antibodies and/or HCV-RNA (incidence of 0.53%). Ten had both anti-HCV and HCV-RNA; four had only anti-HCV; and one had HCV-RNA in the absence of antibody. The incidence rate at all ages was 2.7/1000 person-years (PY). It was 3.8/1000 PY during infancy and 2.0/1000 PY for the 1-5-years age group. Hospitalization and low birth weight increased the risk of infection; while living in village B, the family having a higher socioeconomic status, and advanced maternal education were protective. Six of eight HCV-infected infants reported iatrogenic exposures (e.g. hospitalization, therapeutic injections, ear piercing) prior to infection whereas only 2/7 children older than 1 year reported these exposures. Having an HCV-positive mother was the only other reported risk in two of these older children. The virus cleared in six (40%) children by the end of follow-up. Health education targeting iatrogenic exposures and focusing on risk factors could reduce HCV infection in children in high-risk populations.
一项在三个埃及村庄（A、B 和 C）进行的前瞻性研究，这些村庄 HCV 感染率很高，研究了儿童中社区获得性 HCV 感染的发生率；2852 名未感染的婴儿从出生开始前瞻性随访长达 5.5 年。有 15 名血清学转换为 HCV 抗体和/或 HCV-RNA（发生率为 0.53%）。10 名既有抗-HCV 又有 HCV-RNA；4 名只有抗-HCV；1 名在没有抗体的情况下有 HCV-RNA。所有年龄段的发病率为 2.7/1000 人年（PY）。婴儿期为 3.8/1000 PY，1-5 岁年龄组为 2.0/1000 PY。住院和低出生体重增加了感染的风险；而住在 B 村、家庭社会经济地位较高、母亲受教育程度较高则具有保护作用。在感染前，8 名 HCV 感染婴儿中有 6 名报告了医源性暴露（如住院、治疗性注射、穿耳），而在 1 岁以上的 7 名儿童中，只有 2 名报告了这些暴露。在这两名年龄较大的儿童中，另一个报告的危险因素是 HCV 阳性母亲。到随访结束时，有 6 名（40%）儿童的病毒清除。针对医源性暴露和针对危险因素的健康教育可以降低高危人群中儿童的 HCV 感染。
