Background Virtually all cases of hepatitis C virus (HCV) infection in children in the United States occur through vertical transmission, but it is unknown how many children are infected. Cases of maternal HCV infection have increased in the United States, which may increase the number of children vertically infected with HCV. Infection has long-term consequences for a child's health, but treatment options are now available for children ≥3 years old. Reducing HCV infections in adults could decrease HCV infections in children. Methods Using a stochastic compartmental model, we forecasted incidence of HCV infections in children in the United States from 2022 through 2027. The model considered vertical transmission to children <13 years old and horizontal transmission among individuals 13–49 years old. We obtained model parameters and initial conditions from the literature and the Centers for Disease Control and Prevention's 2021 Viral Hepatitis Surveillance Report. Results Model simulations assuming direct-acting antiviral treatment for children forecasted that the number of acutely infected children would decrease slightly and the number of chronically infected children would decrease even more. Alone, treatment and early screening in individuals 13–49 years old reduced the number of forecasted cases in children and, together, these policy interventions were even more effective. Conclusions Based on our simulations, acute and chronic cases of HCV infection are remaining constant or slightly decreasing in the United States. Improving early screening and increasing access to treatment in adults may be an effective strategy for reducing the number of HCV infected children in the United States.

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预测美国儿童丙型肝炎病毒状况：建模研究

背景 在美国，几乎所有儿童丙型肝炎病毒 (HCV) 感染病例都是通过垂直传播发生的，但尚不清楚有多少儿童被感染。美国孕产妇丙肝病毒感染病例有所增加，这可能会增加丙肝病毒垂直感染儿童的数量。感染会对儿童的健康产生长期影响，但现在可以为 3 岁以上的儿童提供治疗选择。减少成人丙肝病毒感染可以减少儿童丙肝病毒感染。方法 使用随机区室模型，我们预测了 2022 年至 2027 年美国儿童 HCV 感染的发病率。该模型考虑了 13 岁以下儿童的垂直传播和 13-49 岁个体的水平传播。我们从文献和疾病预防控制中心的2021年病毒性肝炎监测报告中获得了模型参数和初始条件。结果 假设对儿童进行直接抗病毒治疗的模型模拟预测，急性感染儿童的数量将略有减少，慢性感染儿童的数量将减少更多。仅对 13-49 岁的个体进行治疗和早期筛查就可以减少儿童的预测病例数，综合起来，这些政策干预措施甚至更加有效。结论 根据我们的模拟，美国的急性和慢性 HCV 感染病例保持稳定或略有下降。改善成人的早期筛查和增加获得治疗的机会可能是减少美国丙型肝炎病毒感染儿童数量的有效策略。