Mother-to-infant transmission of hepatitis C virus

Anti-hepatitis C virus (HCV) antibodies and HCV-RNA were measured in the sera of 22 anti-HCV positive, HIV-1 negative mothers and their infants. ELISA and RIBA II were used for anti-HCV determination. HCV-RNA was measured by a nested polymerase chain reaction. HCV-RNA was found in 12 of 22 mothers. All 22 children were followed for 12 months. All were anti-HCV positive by the fourth month; 18 became anti-HCV negative between the 8th and 12th month. HCV-RNA was detected in 5 of 22 infants in the fourth month. They remained HCV-RNA positive. All children born to HCV-RNA negative mothers were HCV-RNA negative while 5 of 12 babies born to HCV-RNA positive mothers were infected. All five infected babies were born to mothers infected through transfusions or drug use. ALT levels in mothers seemed to have no effect on mother-to-infant transmission. Hence evidence for perinatal transmission of HCV from HCV-RNA positive mothers was demonstrated in the present study.     

Follow-up of transmission of hepatitis C to babies of human immunodeficiency virus-negative women: the role of breast-feeding in transmission

BACKGROUND: The studies on hepatitis C virus (HCV) vertical transmission, the effect of potential risk factors and the role of breast-feeding have reported conflicting results. PATIENTS AND METHODS: Seventy-three infants of 63 anti-HCV-positive and anti-HIV-negative mothers were studied from 1993 to 1999 in the south of Spain. The mean period of follow-up in children was 29.2 +/- 19 months (range, 8 to 76 months); 6 (8%) children were lost to follow-up. Breast milk was studied for HCV-RNA in 68 samples of 35 mothers. RESULTS: Alanine aminotransferase was high in 19 (26%) and HCV-RNA was positive in 46 (63%) pregnant woman. Breast milk HCV-RNA was negative in nonviremic mothers and positive in 20% of the viremic mothers. The overall rate of vertical HCV transmission was 11.9% (n = 8) (95% confidence interval, 6 to 23%) if HCV-RNA was positive one or more times, but only 1.5% (n = 1) (95% confidence interval, 0.1 to 9%) if HCV-RNA was permanently positive. Seven HCV-infected children did not develop antibodies to HCV, and they had a spontaneous clearance of the virus. A 10-month-old baby was HCV-RNA-positive from birth to the end of the follow-up. The genotype in each of the infants was consistent with that of their mother. The rate of HCV transmission was higher for infants of mothers with higher HCV viremia (P < 0.01) and also for infants whose mothers were HCV-RNA-positive in breast milk (P < 0.05). There were no statistically significant differences between other risk factors. CONCLUSION: The presence of transitory viremia without seroconversion indicates that the vertical transmission of HCV is not important. This could be related to the viral charge and ingestion of milk of HCV-RNA-positive mothers. However, to advise avoidance of maternal breast feeding, it would be necessary to conduct larger studies.     

Prospective study of mother-to-infant transmission of hepatitis C virus

BACKGROUND: Mother-to-infant transmission of hepatitis C virus (HCV) could become the main route of HCV infection in the future because there are no methods available to prevent vertical infection. The aim of this study was to determine the incidence of mother-to-infant transmission in infants born to mothers who tested positive for anti-HCV antibodies and to elucidate associated risk factors for transmission. METHODS: Screening was conducted for 16,800 pregnant women with an anti-HCV antibodies test, and 154 mothers were positive. From the positive group 141 mothers were enrolled in the study and their 147 infants were followed from birth for serum alanine aminotransferase activity, anti-HCV antibodies and HCV RNA. HIV infection was tested in 73 of 141 mothers, all of whom were negative. RESULTS: Thirty-three infants were dropped from the study because they were followed for <6 months or were not tested adequately. Of the 114 infants finally evaluated 9 (7.8%) had detectable HCV RNA. The transmission rate was not influenced by the mode of delivery [vaginal delivery, 8 of 90 vs. cesarean section, 1 of 24 (P = 0.396)] or by the type of feeding [9 of 98 for breast-fed infants vs. 0 of 16 for formula-fed infants (P = 0.243)]. All infected infants were born to mothers who had HCV viremia at the delivery (P = 0.040) and to those with a high viral load (P = 0.019). CONCLUSIONS: Our prospective study showed that the transmission rate of mother-to-infant HCV infection was 7.8% in anti-HCV antibody-positive mothers. Risk was related to the presence of maternal HCV viremia at delivery and a high viral load in the mothers.     

Vertical transmission of hepatitis C virus in a cohort of 2,447 HIV-seronegative pregnant women: a 24-month prospective study.

BACKGROUND: Mother to infant transmission of hepatitis C virus (HCV) has been extensively studied in mothers with human immunodeficiency virus (HIV) infection, whereas fewer data are available on the vertical HCV transmission in HIV-negative women. METHODS: Between January 1995 and June 1997, 78 consecutive HCV-positive/HIV-negative women with their offspring entered this prospective study aimed to define the prevalence of and risk factors for HCV vertical transmission. Risk factors for HCV were carefully sought, and HCV viral load and genotype were determined in all positive mothers. The infants were tested for alanine aminotransferase (ALT) and HCV-RNA at birth and at 4, 8, 12, 18, and 24 months of age. RESULTS: Eight of 60 (13.3%) infants born to HCV-RNA positive mothers acquired HCV infection, but only 2 (3,3%) were still infected by the end of follow-up. Infants' genotypes matched that of the mothers. ALT levels were in the normal range in all study subjects throughout the follow-up. High maternal viral load (P < 0.05), possession of HCV risk factors (P < 0.004), and history of blood transfusion (P < 0.05) were associated with increased risk of HCV vertical transmission. CONCLUSIONS: This long-term prospective study shows that, although vertical transmission from HIV-negative mothers occurs in 13% of cases, there is a high rate of spontaneous viral clearance (75%). High maternal viral load and mothers belonging to HCV risk categories were the only variables predictive of the vertical transmission.     

Mother-to-Infant transmission of hepatitis C virus (HCV) in Brazil

Sixty-one women with anti-HCV antibodies, detected by a third-generation enzyme immunoassay (EIA3), were prospectively recruited for investigation of vertical HCV transmission during child-birth, at the University Hospital of the Catholic University of Campinas, Brazil, between January 1994 and July 1998. Six of the women presented coinfection with the human immunodeficiency virus type 1 (HIV-1). All of the 72 children born in this period were followed at least until they were 18 months of age. Analyses of anti-HCV, HCV RNA, and alanine aminotransferase were performed in a minimum of two blood samples during follow-up. One (2.4 per cent; 95 per cent CI, 2.2-7) of the 42 children born to HCV viremic mothers was both anti-HCV and HCV RNA-positive, with altered ALT levels. Passively transferred maternal anti-HCV antibodies became undetectable within 9-12 months. None of the nine infants born to HIV-1 infected mothers were infected either by HIV or HCV. Thus, the mother-infant HCV transmission rate is low and seems to be associated with maternal HCV RNA positivity.     

Hepatitis C virus infection and related liver disease in children of mothers with antibodies to the virus

Objective: To evaluate the clinical, biochemical, and virologic features associated with hepatitis C virus (HCV) infection acquired early in life from mothers with antibodies to HCV (anti-HCV).Study design: Multicenter prospective-retrospective study in Italian children.Patients: Two groups of children were investigated. Group 1 included 14 infants, born to mothers with anti-HCV but without human immunodeficiency virus infection, who became seropositive for HCV RNA during the first year of life and were thus considered infected. Group 2 included 16 children with chronic hepatitis C, aged 1 ½ to 14 years, whose mothers were the unique potential source of infection. Both groups were followed for 12 to 48 months.Methods: Alanine transaminase (ALT), anti-HCV, and HCV RNA were investigated by the polymerase chain reaction on entry to the study and during follow-up.Results: All children in group 1 had anti-HCV throughout follow-up, and all had ALT abnormalities, ranging from 1.5 to 10.5 times the normal value during the first 12 months. During further follow-up, 5 of 10 children had HCV RNA with abnormal ALT values, 3 had a return to normal of the ALT values but continued to have viremia, and 2 eventually had normal ALT values and clearance of HCV RNA. Of the 16 children in group 2, all were free of symptoms and 62% had only slight ALT elevations; 7 who underwent liver biopsy had histologic features of minimal or moderate hepatitis.Conclusions: HCV infection acquired early in life from mothers with anti-HCV is usually associated with biochemical features of liver damage during the first 12 months of life. Progression to chronicity seems to occur in the majority of cases, although HCV-associated liver disease is likely to be mild throughout infancy and childhood. (J Pediatr 1997;130:990-3)     

Transmission of hepatitis C virus from infected mother to offspring during subsequent pregnancies

BACKGROUND: Several studies have demonstrated that hepatitis C virus (HCV) may be transmitted from mother to offspring. To date, however, little is known about the risk of vertical transmission during subsequent pregnancies. The purpose of this study was to evaluate the risk of vertical HCV transmission in offspring in subsequent pregnancies of HCV infected women. METHODS: In a multicenter study, two groups of index cases were selected. Group 1 included 75 children investigated for HCV infection during prospective studies of vertical transmission. Group 2 included children born to HCV-infected mothers and found to be HCV infected, independent of studies on vertical transmission. All children in the index cases had one or more siblings. Anti-HCV, HCV-RNA (determined by polymerase chain reaction), and HCV genotype were evaluated in all the infected children, their mothers, and siblings. RESULTS: The results indicate that a mother who has already delivered an HCV-infected baby is not at greater risk of infecting her second child. Duration of maternal infection does not seem to be a risk factor in offspring infection, because HCV infection is equally distributed among first-born infants and infants of subsequent births. Because clustering of HCV infection among siblings appeared to be rare in this study, data also indirectly confirm that the risk of horizontal transmission of HCV among siblings is low. CONCLUSION: For practical purposes, the current observations indicate that mothers who have already delivered an HCV-infected child can be advised that this event does not increase the probability of infecting the second child.     

The calorie intake and weight gain of low birth weight infants fed on fresh breast milk or a special formula milk

The calorie intake and weight gain of 24 low birth weight (LBW) infants, <33 weeks gestation and <1500 g birth weight, was studied prospectively. Fourteen infants were fed on a commercially available LBW formula milk and ten were fed on their own mother's fresh unpasteurised expressed breast milk (EBM). The difference between the two feeding groups in the intake of milk and calories was not significant, but from the third week onwards those fed on the LBW formula gained weight faster. The mean (±SEM) weight increments for weeks 3–6 (inclusive) for LBW formula and EBM fed infants was 189.3 (±7.9) and 139.6 (±11.1) g/wk respectively (P<0.001).The LBW formula was well tolerated and is a suitable feed for LBW infants. However some babies thrived well on fresh EBM and so we are continuing to encourage mothers who wish, to breast feed their own preterm infants. When such infants fail to thrive it is appropriate to supplement with a LBW formula.     

Evolution in the hypervariable region of hepatitis C virus in infants after vertical transmission

To elucidate the clonal evolution of hepatitis C virus (HCV) during mother-to-infant transmission, we prospectively analyzed HCV clones of the hypervariable region in four HCV RNA-positive infants and compared them with those of the mother. Cord blood samples from three of the four infants were positive for the HCV RNA (< or =10(3) copies/mL), and all of the four infants had the HCV RNA titer of >10(6) copies/mL within 2 mo after birth. The hypervariable region clones detected in the infants were closely related to those in the respective mothers. The results suggest the perinatal transmission of HCV. The hypervariable region clones transmitted to infants were not a single selected clone or minor clones in the mother. None of the clones specific to the low-density fraction in the mother was transmitted to the infants. Moreover, the proportion of HCV in the low-density fraction was minimal in the first few months of life, but increased several months after birth in association with the elevation of alanine aminotransferase. These results suggest that the increase of HCV in the low-density fraction reflect the evolution of immune response in infants. We also demonstrated that the emergence of quasispecies in infants precedes the infantile antibody response.     

Psychomotor development in congenital hypothyroidism

In 1979 a national screening programme for congenital hypothyroidism (CH) was introduced in Greece. Treatment with l-thyroxine was started immediately after confirmation of the diagnosis, at a median age of 28 days. A standardized development test (Griffiths) was given to a group of CH infants and to healthy controls at the ages of 5–7, 11–13, 17–19, and 23–25 months. Thirty-three infants with CH were also studied at the age of 35–37 months. The mean developmental quotient of CH infants was 103.8±12.0, 100.9±10.1, 103.3±7.1 and 99.8±10.2 from the ages of 5–7 to 23–25 months, and was not statistically different from those of the controls. Statistical analysis showed no significant differences between athyreotic children and those with an ectopic gland. Our findings show that the prognosis for psychomotor development of children with CH is quite good, provided that treatment starts in the first 6 weeks of life.Abbreviations (CH) congenital, hypothyroidism - (PD) psychomotor development - (T₄) thyroxine - (TSH) thyrotropin - (DQ) developmental quotient - (SD) standard deviation     

Antenatal hepatitis C virus screening and management of infected women and their children: policies in Europe

A postal survey of 31 European centres was conducted to document current practices regarding screening and management of hepatitis C virus (HCV)-infected pregnant women and their children. Antenatal HCV prevalence was low. Universal antenatal screening programmes were in place in ten centres, selective screening occurred in ten other centres, two did not specify the type of policy, and there was no screening programme in nine centres. Numbers of HCV-infected children were low. Breastfeeding was recommended for infants of infected mothers in ten centres, discouraged in ten centres, in three centres women were merely informed of the risks, and there were no guidelines in eight centres. Polymerase chain reaction was available in all centres. In 17 centres children born to HCV-infected women were seen every 3 months for at least the 1st year. Conclusion The optimum antenatal hepatitis C virus screening approach and the appropriateness of breastfeeding recommendations are unclear and this survey highlights the lack of uniformity in current practice. Received: 15 January 1999 / Accepted: 10 March 1999     

感染丙型肝炎病毒的孕妇及其新生儿随访观察

目的了解丙型肝炎病毒(HCV)母婴垂直传播情况及HCV感染后对新生儿体格发育的影响。方法用ELISA法对1023名孕妇静脉血做抗HCV检测,阳性者对其新生儿脐带血做抗HCV检测。阳性者(包括产妇及其新生儿)进一步做HCVRNA检测;对抗HCV阳性新生儿做10～12个月随访,观察HCV感染指标及新生儿喂养、患病、生长发育情况。结果产妇HCV感染率为2.74％(28/1023);抗HCV阳性产妇中HCVRNA检出率为75％(21/28);抗HCV阳性产妇的新生儿脐血中抗HCV检出率为46.43％(13/28),其中检出HCVRNA阳性5例。对抗HCV阳性新生儿1年随访,抗HCV阴转率为69.23％(9/13),实验组新生儿母乳喂养率57％明显低于对照组85％,实验组儿童人均患病1.25次,而对照组儿童为0.5次,有非常显著性差异,身长、体重指标明显落后于对照组。结论母婴间存在着HCV的垂直传播;HCVRNA的存在不但增加了母婴垂直传播的比率,而且延缓了抗HCV的阴转;HCV的感染非常明显地影响了新生儿的体格发育。     

Spontaneous remission of chronic hepatitis C in children

The clinical course of 48 children with chronic hepatitis C (33 boys, 15 girls; mean age: 12.2 years) was monitored for more than 3 years to clarify its natural course. All patients were positive for the second-generation antibody to hepatitis C virus (anti-HCV) and for serum hepatitis C virus (HCV) RNA. All but one patient had a history of blood transfusion. Serum levels of alanine aminotransferase (ALT) had been abnormal for more than 1.5 years. Spontaneous remission defined as a biochemical remission lasting more than 1 year in association with the disappearance of serum HCV RNA, occurred in 4 (8.3%), however, in 25%, HCV RNA was still detectable in the liver even after its disappearance from serum. In this patient, the level of antibody to HCV core antigen (anti-HCV core) did not decrease significantly and serum HCV RNA eventually reappeared. The serum titre of HCV RNA in the 4 children with spontaneous remission was lower than in the remaining 44 children. Spontaneous remission may occur in children with chronic hepatitis C in whom the serum titre of HCV RNA is low and serum level of anti-HCV core decreases significantly. Assessment of the intrahepatic HCV RNA is necessary to confirm complete remission. Conclusion A low serum titre of HCV RNA and a significant decrease in the serum titre of anti-HCV core were associated with spontaneous remission in children with chronic hepatitis C. Intrahepatic HCV RNA assessment is necessary to confirm complete remission. Received: 9 April 1996 and in revised form: 8 April 1997 / Accepted: 15 April 1997     

Erythrocyte sodium-potassium transport in hyperkalaemic and normokalaemic infants

Abstract One of the causes of early onset hyperkalaemia in very low birth weight infants is presumed to be the dysfunction of K⁺ transport across the cell membrane. Sodiumpotassium adenosine triphosphatase(Na⁺–K⁺ ATPase) is known to play a major role in K⁺ transport. We compared the concentrations of erythrocyte Na⁺–K⁺ ATPase (V_max levels) for hyperkalaemic and normokalaemic infants of matched gestational age. In hyperkalaemic infants, the highest levels of V_max were reached at 24–48 h after birth, but in normokalaemic infants, there were no significant changes in V_max levels during the 1st week after birth. At 12–72 h after birth, erythrocyte K⁺ concentrations for hyperkalaemic infants were higher than those of normokalaemic infants. For both groups of infants, the highest levels of plasma K⁺ during the 1st week after birth showed a positive correlation with those of V_max.Conclusion Na⁺–K⁺ ATPase on the cell membrane is activated to compensate for hyperkalaemia; however, when this compensation is incomplete, hyperkalaemia occurs.     

Breastfeeding and vitamin D status in Greece during the first 6 months of life

Since no foods are vitamin D supplemented in Greece, vitamin D status was assessed in mothers at birth and their infants up to the first 6 months of life, while they were exclusively breast-fed. This was a prospective study. Full-terms ( n =35) born during the summer-autumn months and their mothers were assigned to the summer group and the remainder ( n =31) to the winter group. One week after birth, serum 25-hydroxyvitamin D (25OHD) was significantly lower in the winter-born than in the summer-born neonates (6.7±0.7 vs. 10.1±0.9 ng/ml, P <0.01). The respective levels of parathyroid hormone (iPTH) were 64.9±13.4 and 33.9±4.4 pg/ml ( P <0.01). The mothers had serum 25OHD levels of 10.8±1.0 ng/ml and iPTH levels of 15.2±3.5 pg/ml in the winter and 12.9±1.3 ng/ml and 24.8±4.8 pg/ml in the summer. During the 6-month follow-up, a steady increase in circulating 25OHD (up to 19.4±2.8 ng/ml, P <0.0001) and a decrease in iPTH (to 26.8±3.5 pg/ml, P =0.10) were observed in the infants born in the winter. In the summer-born infants, serum 25OHD did not change but iPTH had increased significantly by the 3rd month (59.4±21.8, P <0.05). Serum calcium (Ca) increased within normal limits during the study period in both groups. Serum phosphorus (Pi) started higher in the winter group (7.43±0.38 vs. 6.27±0.23 mg/dl, P <0.01) but thereafter, it was similar in both groups. Total alkaline phosphatase (ALP) increased in both groups during the study (164±15 vs. 219±17 IU/l, P <0.05 and 189±14 vs. 288±35 IU/l, P <0.001, respectively). Serum osteocalcin (OC) decreased in the winter-born neonates (32.0±3.4 vs. 21.5±3.4 ng/ml, P <0.05) and did not change in the summer group (28.9±3.5 vs. 26.5±2.8 ng/ml). Conclusion:Neonates who are breast-fed exclusively during the first 6 months of life are in need of vitamin D supplementation irrespective of the season even in a sunny country like Greece where foods are not supplemented.     

Growth in the first two years of uninfected children born to HIV-1 seropositive mothers

OBJECTIVE—To assess the growth curves of uninfected infants born to type 1 human immunodeficiency virus (HIV-1) seropositive mothers by means of standardised anthropometric indices.
METHODS—The z scores (National Center for Health Statistics-World Health Organisation data) of weight for age, length for age, and weight for length of 92 uninfected full term infants born to HIV positive mothers were compared with those of 65 bottle fed full term infants born to healthy mothers at 0, 1, 2, 3, 4, 6, 9, 12,18, and (in a subgroup) 24 months of age. Confounders were also recorded.
RESULTS—The study population had a lower length for age z score at birth (95% confidence intervals (CI): 0.02, −0.58) and higher weight for length z scores at 1 (95% CI: 0.21, 0.63), 2 (95% CI: 0.25,0.66), and 3 (95% CI: 0.0, 0.48) months compared with the reference group. After a temporary recovery, the length for age z score difference increased progressively from the 4th month onwards and was significant at 18 (95% CI: −0.31, −1.05) and 24 (95% CI: −0.02, −0.91) months. The difference between the length for age z scores at birth was associated with maternal covariates, but the between group difference at 18 months was apparent even after adjustment for covariates.
CONCLUSION—Uninfected infants born to HIV positive mothers have a rapid weight gain immediately after birth. A decrease in length progression during the second year might be a result of the social risk connected with the family environment and an unfavourable programming related to the maternal HIV status.

     

Addition of orlistat to conventional treatment in adolescents with severe obesity

To investigate the efficacy and tolerability of orlistat in obese adolescents, a prospective, open-label, randomised, controlled pilot trial was performed. A total of 22 adolescents with exogeneous obesity were started on orlistat (120 mg tid) and a daily multivitamin preparation in addition to conventional treatment which included nutritional and lifestyle modification programmes. The control group consisted of 20 obese adolescents who had similar duration of follow-up under conventional treatment alone. Of the 22 patients, 7 dropped out within the 1st month of the trial due to side-effects attributable to orlistat. The remaining 15 patients on orlistat were followed for 5–15 months (average duration of treatment 11.7±3.7 months). The control group was similar in age, sex, and duration of follow-up (10.2±3.7 months, range 6–17 months) to the orlistat group. Compared to initial body weight, patients in the orlistat group lost –6.27±5.4 kg, whereas those in the control group gained 4.16±6.45 kg (P<0.001) during the study period. Patients in the orlistat group lost –7.65%±6.5% of their initial body weight, whereas, those of the control group gained 5.7%±8.3% (P<0.001). The body mass index decreased in the orlistat group by –4.09±2.9 kg/m² while it increased by +0.11±2.49 kg/m² in the control group (P<0.001). Mild gastrointestinal complaints (frequent stools) were experienced by all patients in the orlistat group. Conclusion:Orlistat could be a useful adjunct in the treatment of severe obesity in adolescents; however, gastrointestinal side-effects limit its usefulness in almost one in three adolescents.This work was presented in part at the 41st Annual Meeting of the ESPE, Madrid, 2002.     

Growth in the first 5 years of life is unaffected in children with perinatally-acquired hepatitis C infection

OBJECTIVES: To identify the effect of vertical hepatitis C virus (HCV) infection or exposure on growth in childhood. STUDY DESIGN: Children (n=1203) born to HCV-infected mothers were followed up from birth prospectively in centers of the European Paediatric Hepatitis C virus Network. Z-scores compared height- and weight-for-age in HCV-infected and -uninfected children, adjusting for other factors using linear regression. We also quantified the effect of maternal chronic infection with HCV on childhood growth. RESULTS: There was no significant effect of vertical HCV infection on growth (height P=.223, weight P=.095) nor a significant effect of maternal chronic infection with HCV (height P=.733, weight P=.274). Prematurity and maternal injecting drug use were associated with a significant reduction in height (P < .001) and weight (P < .001) in all HCV-exposed children. CONCLUSIONS: This population of HCV exposed infants has higher rates of maternal injecting drug use and prematurity than standard populations and so there are implications for growth of these children, but this is not a direct result of HCV infection or exposure to chronic maternal HCV infection.     

Factors associated with variation in plasma copper levels in preterm infants of very low birth weight

At 2-weekly intervals from age 4–14 weeks, the possible effects on plasma copper concentration of gestation, multiple birth, fractional weight change from birth (W/BW) and, up to 10 weeks, average daily total copper intake from birth were explored in 43 preterm infants of very low birth weight. There was no significant association between the logarithm of the plasma copper concentration (ln Cu) and multiple birth at any time and no significant association between lnCu and gestation was found from 4–12 weeks. From age 4–10 weeks, there was a significant negative correlation between lnCu and W/BW and at 4, 6 and 10 weeks there was also a significant negative correlation between lnCu and copper intake. W/BW and copper intake were correlated throughout. At 14 weeks, lnCu correlated positively with gestation and negatively with W/BW but, at this age, gestation and W/BW were correlated. The maximum total variation (R²) in lnCu explained by its regression on gestation, multiple birth, W/BW and/or copper intake combined was only about 31% (at 10 weeks). The potential for copper depletion may be greater in rapidly growing infants.     

Hair selenium content during infancy and childhood

Hair selenium content was estimated by instrumental neutron activation analysis in Libyan infants and children. There was no significant difference between the values of young infants from North and South Libya. The hair selenium content rapidly decreased from 1071 ±75 ng/g in newborns to 301±99 ng/g in 7–10 months old infants in North Libya and to 557±204 ng/g in South Libya. In North Libya the values of preschool children were 409±117 ng/g and those of school children 464±124 ng/g.