Study Finds Most Children with Hep C have Developmental Disorder, Learning Difficulty

Research from a review of medical records data by a team at BC Children's Hospital suggests the presence of hepatitis C virus (HCV) could predispose children to neurodevelopmental disorders.

The study, which was presented at the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) 2024 annual meeting, suggests 62% of children with HCV experienced some neurodevelopmental disorder or learning difficulties.¹

“In our study population of children with chronic HCV, a majority had at least 1 documented neurodevelopmental disorder. This represents a previously undescribed issue among pediatric patients with chronic HCV,” investigators wrote.¹

Despite the advent of efficacious direct-acting antiviral therapy, eradication of HCV eludes the medical community, with many pointing to the rise of illicit drug use as a public health crisis as a primary contributor. The downstream effect of this has been a growing concern over the impact of vertical transmission, the leading cause of chronic HCV in children, given the rise in HCV-positive pregnancies.^1,2

In July 2023 study published in JAMA Network Open detailed this crisis through the lens of US Centers for Disease Control and Prevention data. According to the study, a 16-fold increase in prevalence of HCV-positive pregnancies occurred in the US from 1998 to 2018, with a 31-fold increase observed among mothers aged 21 to 30 years.²

Conducted by a pair of physicians at BC Children’s Hospital, Shreya Kishore, MD, a pediatric hospital medicine and gastroenterology fellow, and Orlee Guttman, MD, a pediatric gastroenterologist, the NASPGHAN 2024 study sought to better illustrate associations between chronic HCV and risk of neurodevelopmental disorders among children in the province of British Columbia.¹

With this in mind, investigators designed their study as a retrospective review of medical record data for all children actively followed at BC Children’s Hospital from December 2020 to April 2024. Investigators pointed out BC Children’s Hospital is the only pediatric referral center for chronic HCV in the province of British Columbia, which they suggest implies the likely representation of the whole known population of HCV positive e children in British Columbia.¹

The investigators’ search yielded 29 individuals less than 18 years of age with chronic HCV. This cohort included 13 males and 16 females. Investigators pointed out 28 patients had HCV as the result of vertical transmission and 1 had HCV of unknown cause.¹

Analysis of the 29-patient cohort suggested 48% (n=14) were diagnosed with attention deficit hyperactivity disorder (ADHD). Investigators contrasted this with recent data suggesting the prevalence of ADHD among those aged 4 to 17 years across all 5 Canadian provinces was approximately 8.6%. Among those with ADHD, 43% (n=6) also had fetal alcohol spectrum disorder, 21% (n=3) had autism spectrum disorder, and 14% (n=2) had other learning and developmental difficulties, including speech delay and sensory processing issues.¹

Further analysis of the entire study cohort revealed 14% (n=4) of the entire study cohort had speech delay, with 1 also having autism. In total, 62% (n=18) of patients had a neurodevelopmental disorder or learning difficulty.¹

“Based on these results, we suggest that practitioners who care for children with chronic HCV may have a role in proactively identifying patients with neurodevelopmental difficulties and linking them with appropriate resources,” investigators added.¹

References:

1. Kishore S, Gutman O. CHILDREN WITH CHRONIC HEPATITIS C HAVE A HIGH PREVALENCE OF NEURODEVELOPMENTAL DISORDERS. Presented at NASPGHAN 2024. Hollywood, Florida. November 7 – November 9, 2024.
2. Chen P, Johnson L, Limketkai BN, et al. Trends in the Prevalence of Hepatitis C Infection During Pregnancy and Maternal-Infant Outcomes in the US, 1998 to 2018. JAMA Netw Open. 2023;6(7):e2324770. doi:10.1001/jamanetworkopen.2023.24770