The Centers for Disease Control and Prevention (CDC) released four new recommendations for hepatitis C virus (HCV) screening for infants and children exposed perinatally, according to Medpage Today. Perinatal refers to the time around the birth of a child, both before and after birth.

It’s estimated that 2.4 million Americans were living with chronic HCV between 2013 and 2016 (about 1% of the adult population), according to the CDC. What’s more, 14,242 people died of HCV in 2019, and acute HCV cases quadrupled from 2009 to 2019.

Women who are infected with HCV have a 6% chance of passing the virus along to their babies during pregnancy or delivery. The risk increases significantly if the woman has HIV, hepatitis B or a high HCV viral load (the amount of HCV in a measurement of blood). The HCV transmission risk is doubled or tripled in women with HIV. It is unlikely that hep C can be transmitted through breastfeeding or breast milk, according to Hep Mag’s Health Basics on HCV.

The new recommendations from the MMWR Recommendations and Reports read:

  • All perinatally exposed infants should be screened for HCV with a nucleic acid test (NAT) for detection of HCV RNA at ages 2 to 6 months;
  • All infants and kids with detectable HCV RNA should see a health care provider with expertise in pediatric hepatitis C management;
  • Exposed infants and kids with an undetectable HCV RNA result at or after 2 months of age do not need to seek further follow-up unless “clinically warranted”;
  • An NAT for HCV RNA is recommended for perinatally exposed infants and children ages 7 to 17 months who previously have not been tested, and an HCV antibody test followed by a reflex NAT for HCV RNA (when anti-HCV is reactive) is recommended for perinatally exposed kids ages 18 months and older who previously have not been tested.

Rates of HCV have been rising among people of reproductive age and pregnant people. A study published this year found that from 1998 to 2018, the prevalence of HCV among pregnant women of all ages increased 16-fold. This in turn increases the risk for poor fetal development, preterm birth and fetal distress, which occurs when the baby does not receive enough oxygen through the placenta during pregnancy or labor.  

According to Medpage, Lakshmi Panagiotakopoulos, MD, of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, and colleagues reviewed data from 12 studies and found that only about 30% of perinatally exposed infants and children are tested for HCV.

Panagiotakopoulos noted that although HCV develops in 6% to 7% of perinatally exposed infants and children, many remain undiagnosed. She attributes this in part to a "lack of awareness of perinatal exposure by pediatric providers, lack of regular pediatric care among exposed children and changes in health care providers before the time of HCV testing (currently recommended at age 18 months).”

Researchers said beginning to test perinatally exposed infants at 2 months of age "is cost effective and allows for earlier linkage to care, appropriate evaluation and the opportunity to provide curative, lifesaving therapy.”

“Regardless of when a child is seen by a provider, opportunities exist for education, testing and evaluation, curative treatment and progress toward the goal of hepatitis C elimination,” the authors concluded.

To learn more, click #Hepatitis C Testing. There, you’ll find headlines such as “Egypt Makes Unprecedented Progress Towards Eliminating Hepatitis C,” “HCV Testing at Safe Injection Site Improves Treatment Uptake” and “Cherokee Nation Awarded $450K for Hep C Linkage to Care Program.”