Expected and Actual Case Ascertainment and Treatment Rates for Children Infected with Hepatitis C in Florida and the United States: Epidemiologic Evidence from Statewide and Nationwide Surveys

• Published in: The Journal of pediatrics Vol. 161; no. 5; pp. 915 - 921
• Main Authors: Delgado-Borrego, Aymin, MD, MPH, Smith, Lesley, MD, Jonas, Maureen M., MD, Hall, Cyndena A., BA, Negre, Betania, MD, Jordan, Sergio H., MD, Ogrodowicz, Matthew, Raza, Roshan, MD, Ludwig, David A., PhD, Miller, Tracie, MD, Lipshultz, Steven E., MD, Gonzalez-Peralta, Regino, MD, Chung, Raymond T., MD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01.11.2012; Mosby, Inc; Elsevier
• Subjects: Adolescent; Biological and medical sciences; Child; children; Epidemiology; Female; Florida; General aspects; health care costs; Health Surveys; Hepacivirus - metabolism; hepatitis C; Hepatitis C - diagnosis; Hepatitis C - epidemiology; Hepatitis C - therapy; Hepatitis C Antibodies - immunology; Hepatitis C virus; Human viral diseases; Humans; Infectious Disease Medicine - methods; Infectious diseases; Male; Medical sciences; morbidity; mortality; national surveys; Nutrition Surveys; Pediatrics; Pediatrics - methods; Prevalence; public health; Public Health - methods; Public health. Hygiene; Public health. Hygiene-occupational medicine; questionnaires; risk groups; United States; Viral diseases; Viral hepatitis; Florida; United States; North America; America; MERLIN; Medical Emergency Relief International; IOM; HCV; NHANES; Institute of Medicine; Hepatitis C virus; National Health and Nutrition Examination Survey; Sustained virologic response; SVR; Human; Pediatrics; Rate; Hepatic disease; Epidemiology; Infection; Survey; Treatment; Surveillance; Viral disease; Digestive diseases; Child; Public health; Viral hepatitis C
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2012.05.002

Objective To evaluate the rate of pediatric hepatitis C virus (HCV) case ascertainment relative to the estimated number of actual cases. Study design Data from Florida and United States health departments were used to assess pediatric HCV case ascertainment rates in Florida and nationwide. The percentage of children infected with HCV from Miami-Dade County receiving medical care by a pediatric gastroenterologist was estimated based on data obtained from physician questionnaires. Results From 2000 through 2009, 2007 children were identified as having positive HCV antibody tests in Florida, only 12% of the expected number (n = 12 155). An estimated 1.6% of the expected children with HCV who tested Ab-positive (37 of 1935) were actively followed by a pediatric gastroenterologist in Miami-Dade County, Florida. Across the United States, only 4.9% of the expected cases have been identified. Conclusions The identification of children infected with HCV in the nation as a whole is grossly inadequate. Only a small fraction of cases are identified. In Florida, less than 2% of children identified receive treatment. Lack of identification and lack of treatment of children infected with HCV constitute critical public health problems. Strategies to increase awareness of HCV infection and to screen at-risk individuals could substantially improve morbidity and mortality while reducing health care costs.