Hepatitis C prevalence in children with perinatal human immunodeficiency virus infection enrolled in a long-term follow-up protocol

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/mm(3). 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.