Department of Pediatrics, General Hospital TZANEIO, Piraeus.
Center for Clinical Epidemiology and Outcomes Research (CLEO), Athens.
J Pediatr Gastroenterol Nutr. 2021 Jun 1;72(6):e140-e148. doi: 10.1097/MPG.0000000000003099.
Hepatitis C virus (HCV) remains a major public health burden for >30 years since its discovery. It is estimated that >80 million people have been already infected. Direct-acting antiviral (DAA) treatment is now approved for young children over the age of 3 years. Treating children before the development of high-risk behaviors is optimal. Thus, assessing the current epidemiology of HCV in children becomes important and may promote awareness.
Articles describing the prevalence of hepatitis C in children, were systematically reviewed. To assess HCV infection prevalence in the general population, studies discussing high-risk groups alone were excluded.
Data from 58 studies were analyzed. National data was scarce. An overall prevalence of HCV in children of 0.87% was found, ranging from 0.34% in Europe to 3.02% in Africa. Prevalence of viremic infection is important and data synthesis from available data indicated that HCV viremia was detected in 56.8% of children. The prevalence of HCV according to sex was described in 25 studies but no difference between sexes was detected. HCV prevalence was significantly higher in children older than 10 years (0.97%) when compared to those ages under 10 years old (0.75%, P < 0.001).
Considering probable underdiagnosis of HCV infection in children, this information reveals that prevalence is substantial. One may argue that future strategies aiming towards HCV elimination, may need to include antiviral treatment of pre-adolescent children as well.
自丙型肝炎病毒 (HCV) 发现以来，其已成为 30 多年来的主要公共卫生负担。据估计，已有超过 8000 万人感染。直接作用抗病毒 (DAA) 治疗现已批准用于 3 岁以上的儿童。在儿童出现高危行为之前进行治疗是最佳选择。因此，评估 HCV 在儿童中的当前流行病学情况变得很重要，这可能会提高人们的认识。
系统地回顾了描述儿童丙型肝炎流行情况的文章。为了评估普通人群中 HCV 感染的流行率，单独讨论高危人群的研究被排除在外。
对 58 项研究的数据进行了分析。国家数据稀缺。发现儿童 HCV 的总体流行率为 0.87%，范围从欧洲的 0.34%到非洲的 3.02%。病毒血症感染的流行率很重要，从现有数据综合来看，56.8%的儿童检测到 HCV 病毒血症。有 25 项研究描述了 HCV 按性别流行的情况，但未发现性别之间存在差异。与 10 岁以下的儿童相比，10 岁以上的儿童 HCV 流行率（0.97%）明显更高（0.75%，P<0.001）。
考虑到儿童 HCV 感染可能存在漏诊，这些信息表明其流行率相当高。人们可能会认为，未来旨在消除 HCV 的策略可能需要包括对青春期前儿童进行抗病毒治疗。
