Seroprevalence of Hepatitis C in Children without Identifiable Risk-Factors: A Systematic Review and Meta-Analysis.

OBJECTIVES Hepatitis C virus (HCV) remains a major public health burden for more than 30 years since its discovery. It is estimated that more than 80 million people have been already infected. 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. METHODS Articles describing 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. RESULTS Data from fifty-eight 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 viraemic 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 gender was described in twenty-five 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 aged under 10 years old (0.75%, p < 0.001). CONCLUSIONS 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. An infographic is available for this article at:http://links.lww.com/MPG/C253.