Epidemiological profile of 806 Italian children with hepatitis C virus infection over a 15-year period

Background/Aims To evaluate the epidemiological profile of Italian children with hepatitis C virus (HCV) infection over a 15-year period. Methods Fifteen tertiary care centers, belonging to a national Observatory established in 1998, retrospectively/prospectively recruited 806 consecutive HCV-infected, otherwise healthy, children seen from 1990 to 2004. Results Seven hundred and sixty four were Italian and 42 from foreign countries. Newly-diagnosed cases declined from 332 in 1995–1999 to 196 in 2000–2004, while the proportion of foreign children rose from 3% to 13%. Transfusion-transmitted infection disappeared after 1992. Maternal infection (with drug abuse in 63% of cases in the North) has become the most important mode of HCV diffusion throughout Italy and the exclusive source for all children infected in 2000–2004. The prevalence of HCV genotypes 3 and 4 increased and that of genotype 1b decreased significantly (p < 0.02). Male/female ratio was significantly (p < 0.001) lower among vertically infected (0.6) than in transfused children (1.3). Conclusions The number of children with newly-diagnosed HCV infection is declining in Italy and most post-transfusion cases are now young adults. Thus foreign children could significantly contribute to the reservoir of pediatric infection in years to come. New infections result from maternal transmission and seem to privilege females and genotypes 3 and 4.