Hepatitis C Prevalence in Children With Perinatal Human Immunodeficiency Virus Infection Enrolled in a Long-term Follow-up Protocol

[Guest guest]

JOURNAL OF PEDIATRICS AND ADOLESCENT MEDICINE

Vol. 158 No. 10, October 2004

Hepatitis C Prevalence in Children With Perinatal Human Immunodeficiency

Virus Infection Enrolled in a Long-term Follow-up Protocol

Schuval, MD; B. Van Dyke, MD; Jane C. Lindsey, ScD;

Palumbo, MD; Lynne M. Mofenson, MD; M. Oleske, MD; ph Cervia, MD;

Kovacs, MD; Wayne N. Dankner, MD; , MD; Barbara Nowak;

Ciupak; Webb; Eagle; Dorothy ; Roslyn Hennessey;

Goodman-Kerkau; Myron J. Levin, MD; for the Pediatric AIDS Clinical

Trials Group Protocol 1028S Team

Arch Pediatr Adolesc Med. 2004;158:1007-1013.

Objective To evaluate the prevalence of hepatitis C virus (HCV) infection

in children with perinatal human immunodeficiency virus (HIV) infection.

Design Cross-sectional substudy.

Setting Multicenter study from 41 sites in the United States.

Patients Children with perinatal HIV infection were randomly selected from

a large, long-term, follow-up protocol.

Main Outcome Measure Hepatitis C infection was defined as having positive

test results on both HCV antibody and HCV RNA assays.

Results Five hundred thirty children enrolled in the substudy; definitive

HCV test results were available for 525 children. Eighty-three percent were

of a minority race or ethnicity.They were equally distributed by sex, had a

median age of 10.7 years, and were relatively healthy, with 75% having CD4+

lymphocyte counts greater than 500 cells/mm3. Eight of 525 children (1.5%;

95% confidence interval [CI], 0.7%-3.0%) infected with HIV were coinfected

with HCV. In contrast, the rate of HCV infection in a serosurvey of more

than 2700 children aged 6 to 11 years from the National Health and Nutrition

Examination Survey was 0.2% (95% CI, 0.04%-0.6%). In our study, there were

no differences between children coinfected with HIV and HCV and those

without HCV infection in terms of demographic characteristics, CD4+ or CD8+

T-lymphocyte counts, HIV 1 RNA levels, preterm or mode of delivery, or liver

disease; however, the number of children coinfected with HIV and HCV was

small.

Conclusion While HCV prevalence infection rates are low in children with

perinatal HIV infection, they are 8 to 10 times higher than reported in HCV

serosurveys of children in the United States.

Author Affiliations: Schneider Children's Hospital, Long Island Jewish

Medical Center, New Hyde Park, NY (Drs Schuval and Cervia); Tulane

University Health Sciences Center, New Orleans, La (Dr Van Dyke);

Statistical and Data Analysis Center, Harvard School of Public Health,

Boston, Mass (Dr Lindsey); University of Medicine and Dentistry of New

Jersey, Newark (Drs Oleske and Palumbo); National Institute of Child Health

and Human Development, Rockville, Md (Dr Mofenson); University of Southern

California Medical Center, Los Angeles, Calif (Dr Kovacs); PAREXEL

International and Duke University Medical Center, Durham, NC (Dr Dankner);

National Institute of Allergy and Infectious Diseases, Bethesda, Md (Dr

); Frontier Science and Technology Research Foundation, Amherst, NY (Dr

Nowak, Mr Ciupak, and Ms Web) University of Florida Health Science Center,

ville (Ms Eagle); University of Massachusetts Memorial Health Care,

Worcester (Ms D. ); Westat, Inc, Rockville (Ms Hennessey); University

of North Carolina Retrovirology Core Laboratory, Chapel Hill, NC (Ms

Goodman-Kerkau); and the University of Colorado Health Sciences Center,

Denver (Dr Levin).

[Guest guest]

JOURNAL OF PEDIATRICS AND ADOLESCENT MEDICINE

Vol. 158 No. 10, October 2004

Hepatitis C Prevalence in Children With Perinatal Human Immunodeficiency

Virus Infection Enrolled in a Long-term Follow-up Protocol

Schuval, MD; B. Van Dyke, MD; Jane C. Lindsey, ScD;

Palumbo, MD; Lynne M. Mofenson, MD; M. Oleske, MD; ph Cervia, MD;

Kovacs, MD; Wayne N. Dankner, MD; , MD; Barbara Nowak;

Ciupak; Webb; Eagle; Dorothy ; Roslyn Hennessey;

Goodman-Kerkau; Myron J. Levin, MD; for the Pediatric AIDS Clinical

Trials Group Protocol 1028S Team

Arch Pediatr Adolesc Med. 2004;158:1007-1013.

Objective To evaluate the prevalence of hepatitis C virus (HCV) infection

in children with perinatal human immunodeficiency virus (HIV) infection.

Design Cross-sectional substudy.

Setting Multicenter study from 41 sites in the United States.

Patients Children with perinatal HIV infection were randomly selected from

a large, long-term, follow-up protocol.

Main Outcome Measure Hepatitis C infection was defined as having positive

test results on both HCV antibody and HCV RNA assays.

Results Five hundred thirty children enrolled in the substudy; definitive

HCV test results were available for 525 children. Eighty-three percent were

of a minority race or ethnicity.They were equally distributed by sex, had a

median age of 10.7 years, and were relatively healthy, with 75% having CD4+

lymphocyte counts greater than 500 cells/mm3. Eight of 525 children (1.5%;

95% confidence interval [CI], 0.7%-3.0%) infected with HIV were coinfected

with HCV. In contrast, the rate of HCV infection in a serosurvey of more

than 2700 children aged 6 to 11 years from the National Health and Nutrition

Examination Survey was 0.2% (95% CI, 0.04%-0.6%). In our study, there were

no differences between children coinfected with HIV and HCV and those

without HCV infection in terms of demographic characteristics, CD4+ or CD8+

T-lymphocyte counts, HIV 1 RNA levels, preterm or mode of delivery, or liver

disease; however, the number of children coinfected with HIV and HCV was

small.

Conclusion While HCV prevalence infection rates are low in children with

perinatal HIV infection, they are 8 to 10 times higher than reported in HCV

serosurveys of children in the United States.

Author Affiliations: Schneider Children's Hospital, Long Island Jewish

Medical Center, New Hyde Park, NY (Drs Schuval and Cervia); Tulane

University Health Sciences Center, New Orleans, La (Dr Van Dyke);

Statistical and Data Analysis Center, Harvard School of Public Health,

Boston, Mass (Dr Lindsey); University of Medicine and Dentistry of New

Jersey, Newark (Drs Oleske and Palumbo); National Institute of Child Health

and Human Development, Rockville, Md (Dr Mofenson); University of Southern

California Medical Center, Los Angeles, Calif (Dr Kovacs); PAREXEL

International and Duke University Medical Center, Durham, NC (Dr Dankner);

National Institute of Allergy and Infectious Diseases, Bethesda, Md (Dr

); Frontier Science and Technology Research Foundation, Amherst, NY (Dr

Nowak, Mr Ciupak, and Ms Web) University of Florida Health Science Center,

ville (Ms Eagle); University of Massachusetts Memorial Health Care,

Worcester (Ms D. ); Westat, Inc, Rockville (Ms Hennessey); University

of North Carolina Retrovirology Core Laboratory, Chapel Hill, NC (Ms

Goodman-Kerkau); and the University of Colorado Health Sciences Center,

Denver (Dr Levin).

[Guest guest]

JOURNAL OF PEDIATRICS AND ADOLESCENT MEDICINE

Vol. 158 No. 10, October 2004

Hepatitis C Prevalence in Children With Perinatal Human Immunodeficiency

Virus Infection Enrolled in a Long-term Follow-up Protocol

Schuval, MD; B. Van Dyke, MD; Jane C. Lindsey, ScD;

Palumbo, MD; Lynne M. Mofenson, MD; M. Oleske, MD; ph Cervia, MD;

Kovacs, MD; Wayne N. Dankner, MD; , MD; Barbara Nowak;

Ciupak; Webb; Eagle; Dorothy ; Roslyn Hennessey;

Goodman-Kerkau; Myron J. Levin, MD; for the Pediatric AIDS Clinical

Trials Group Protocol 1028S Team

Arch Pediatr Adolesc Med. 2004;158:1007-1013.

Objective To evaluate the prevalence of hepatitis C virus (HCV) infection

in children with perinatal human immunodeficiency virus (HIV) infection.

Design Cross-sectional substudy.

Setting Multicenter study from 41 sites in the United States.

Patients Children with perinatal HIV infection were randomly selected from

a large, long-term, follow-up protocol.

Main Outcome Measure Hepatitis C infection was defined as having positive

test results on both HCV antibody and HCV RNA assays.

Results Five hundred thirty children enrolled in the substudy; definitive

HCV test results were available for 525 children. Eighty-three percent were

of a minority race or ethnicity.They were equally distributed by sex, had a

median age of 10.7 years, and were relatively healthy, with 75% having CD4+

lymphocyte counts greater than 500 cells/mm3. Eight of 525 children (1.5%;

95% confidence interval [CI], 0.7%-3.0%) infected with HIV were coinfected

with HCV. In contrast, the rate of HCV infection in a serosurvey of more

than 2700 children aged 6 to 11 years from the National Health and Nutrition

Examination Survey was 0.2% (95% CI, 0.04%-0.6%). In our study, there were

no differences between children coinfected with HIV and HCV and those

without HCV infection in terms of demographic characteristics, CD4+ or CD8+

T-lymphocyte counts, HIV 1 RNA levels, preterm or mode of delivery, or liver

disease; however, the number of children coinfected with HIV and HCV was

small.

Conclusion While HCV prevalence infection rates are low in children with

perinatal HIV infection, they are 8 to 10 times higher than reported in HCV

serosurveys of children in the United States.

Author Affiliations: Schneider Children's Hospital, Long Island Jewish

Medical Center, New Hyde Park, NY (Drs Schuval and Cervia); Tulane

University Health Sciences Center, New Orleans, La (Dr Van Dyke);

Statistical and Data Analysis Center, Harvard School of Public Health,

Boston, Mass (Dr Lindsey); University of Medicine and Dentistry of New

Jersey, Newark (Drs Oleske and Palumbo); National Institute of Child Health

and Human Development, Rockville, Md (Dr Mofenson); University of Southern

California Medical Center, Los Angeles, Calif (Dr Kovacs); PAREXEL

International and Duke University Medical Center, Durham, NC (Dr Dankner);

National Institute of Allergy and Infectious Diseases, Bethesda, Md (Dr

); Frontier Science and Technology Research Foundation, Amherst, NY (Dr

Nowak, Mr Ciupak, and Ms Web) University of Florida Health Science Center,

ville (Ms Eagle); University of Massachusetts Memorial Health Care,

Worcester (Ms D. ); Westat, Inc, Rockville (Ms Hennessey); University

of North Carolina Retrovirology Core Laboratory, Chapel Hill, NC (Ms

Goodman-Kerkau); and the University of Colorado Health Sciences Center,

Denver (Dr Levin).

[Guest guest]

JOURNAL OF PEDIATRICS AND ADOLESCENT MEDICINE

Vol. 158 No. 10, October 2004

Hepatitis C Prevalence in Children With Perinatal Human Immunodeficiency

Virus Infection Enrolled in a Long-term Follow-up Protocol

Schuval, MD; B. Van Dyke, MD; Jane C. Lindsey, ScD;

Palumbo, MD; Lynne M. Mofenson, MD; M. Oleske, MD; ph Cervia, MD;

Kovacs, MD; Wayne N. Dankner, MD; , MD; Barbara Nowak;

Ciupak; Webb; Eagle; Dorothy ; Roslyn Hennessey;

Goodman-Kerkau; Myron J. Levin, MD; for the Pediatric AIDS Clinical

Trials Group Protocol 1028S Team

Arch Pediatr Adolesc Med. 2004;158:1007-1013.

Objective To evaluate the prevalence of hepatitis C virus (HCV) infection

in children with perinatal human immunodeficiency virus (HIV) infection.

Design Cross-sectional substudy.

Setting Multicenter study from 41 sites in the United States.

Patients Children with perinatal HIV infection were randomly selected from

a large, long-term, follow-up protocol.

Main Outcome Measure Hepatitis C infection was defined as having positive

test results on both HCV antibody and HCV RNA assays.

Results Five hundred thirty children enrolled in the substudy; definitive

HCV test results were available for 525 children. Eighty-three percent were

of a minority race or ethnicity.They were equally distributed by sex, had a

median age of 10.7 years, and were relatively healthy, with 75% having CD4+

lymphocyte counts greater than 500 cells/mm3. Eight of 525 children (1.5%;

95% confidence interval [CI], 0.7%-3.0%) infected with HIV were coinfected

with HCV. In contrast, the rate of HCV infection in a serosurvey of more

than 2700 children aged 6 to 11 years from the National Health and Nutrition

Examination Survey was 0.2% (95% CI, 0.04%-0.6%). In our study, there were

no differences between children coinfected with HIV and HCV and those

without HCV infection in terms of demographic characteristics, CD4+ or CD8+

T-lymphocyte counts, HIV 1 RNA levels, preterm or mode of delivery, or liver

disease; however, the number of children coinfected with HIV and HCV was

small.

Conclusion While HCV prevalence infection rates are low in children with

perinatal HIV infection, they are 8 to 10 times higher than reported in HCV

serosurveys of children in the United States.

Author Affiliations: Schneider Children's Hospital, Long Island Jewish

Medical Center, New Hyde Park, NY (Drs Schuval and Cervia); Tulane

University Health Sciences Center, New Orleans, La (Dr Van Dyke);

Statistical and Data Analysis Center, Harvard School of Public Health,

Boston, Mass (Dr Lindsey); University of Medicine and Dentistry of New

Jersey, Newark (Drs Oleske and Palumbo); National Institute of Child Health

and Human Development, Rockville, Md (Dr Mofenson); University of Southern

California Medical Center, Los Angeles, Calif (Dr Kovacs); PAREXEL

International and Duke University Medical Center, Durham, NC (Dr Dankner);

National Institute of Allergy and Infectious Diseases, Bethesda, Md (Dr

); Frontier Science and Technology Research Foundation, Amherst, NY (Dr

Nowak, Mr Ciupak, and Ms Web) University of Florida Health Science Center,

ville (Ms Eagle); University of Massachusetts Memorial Health Care,

Worcester (Ms D. ); Westat, Inc, Rockville (Ms Hennessey); University

of North Carolina Retrovirology Core Laboratory, Chapel Hill, NC (Ms

Goodman-Kerkau); and the University of Colorado Health Sciences Center,

Denver (Dr Levin).