In past years, hepatitis C was found with high prevalence in children who received multiple transfusions of blood derived products before testing for hepatitis C was introduced. Currently, age-related distribution of infection is likely related to different patterns of exposure. Vertical transmission in infants and body piercing, tattooing and drug abuse in adolescents are the most common routes of infection. The rate at which the initial infection becomes chronic in infants is still unknown. Up to 30% of these children appear to have spontaneous resolution of their infection.

Although progression of the disease seems to be more benign in children than in adults, some children do develop significant fibrosis. Uncontrolled trials suggest that the response rate to interferon may be as high as 33-50% (82-84). The response to combination therapy (interferon and ribavirin) is unknown. The indications for treatment in children with hepatitis C have not been adequately defined.