Hep C testing recommendations developed for perinatally exposed infants

Recommendations have been developed for hepatitis C virus (HCV) testing among perinatally exposed infants. The recommendations and report are published in the Nov. 3 issue of Morbidity and Mortality Weekly Report.

Noting that about 6–7% of perinatally exposed infants and children will acquire HCV infection and that many perinatally infected children are not tested or linked to care, Lakshmi Panagiotakopoulos, M.D., from the CDC in Atlanta, and colleagues introduced four new recommendations for HCV screening of perinatally exposed infants and children.

The report issued four recommendations:

• All perinatally exposed infants should undergo HCV testing at age two to six months with a nucleic acid test (NAT) for HCV RNA detection.
• All infants and children with detectable HCV RNA should consult with health care providers with expertise in pediatric hepatitis C management.
• No further follow-up or testing is recommended for perinatally exposed infants and children with an undetectable HCV RNA result at or after age two months, unless clinically warranted.
• NAT is recommended for perinatally exposed infants and children aged seven to 17 months who have not been tested previously.

For perinatally exposed children aged 18 months and older who have not been tested previously, hepatitis C virus antibody testing is recommended, followed by NAT for HCV RNA.

"Using a testing strategy of highly sensitive and specific NATs for RNA detection among infants and children perinatally exposed to HCV increases the identification of children with HCV infection in whom substantial morbidity and mortality might develop," the authors write.

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