The Centers for Disease Control and Prevention (CDC) recently issued four updated recommendations for hepatitis C virus (HCV) screening in infants and children who have been exposed perinatally. Perinatal exposure refers to the period surrounding the birth of a child, including both before and after delivery.
According to the CDC, it is estimated that around 1% of the adult population in the United States, or approximately 2.4 million Americans, were living with chronic HCV between 2013 and 2016. Tragically, HCV-related deaths reached 14,242 in 2019, and the number of acute HCV cases has quadrupled from 2009 to 2019.
During pregnancy or delivery, women infected with HCV have a 6% chance of transmitting the virus to their babies. This risk becomes significantly higher if the woman is also infected with HIV, hepatitis B, or has a high HCV viral load. However, it is important to note that breastfeeding or breast milk is unlikely to transmit the hepatitis C virus, according to Hep Mag’s Health Basics on HCV.
The updated recommendations from the MMWR Recommendations and Reports include guidelines such as:
– All infants exposed perinatally should undergo HCV screening between the ages of 2 to 6 months using a nucleic acid test (NAT) to detect HCV RNA.
– Infants and children with detectable HCV RNA should receive care from healthcare providers specializing in pediatric hepatitis C management.
– Infants and children with undetectable HCV RNA results at or after 2 months of age do not require further follow-up unless medically necessary.
– Perinatally exposed children between the ages of 7 to 17 months who have not been previously tested should undergo an NAT for HCV RNA. For those aged 18 months or older who have not been tested before, it is recommended to perform an HCV antibody test followed by an NAT for HCV RNA if the antibody test is reactive.
The prevalence of HCV among pregnant women of all ages has increased significantly over the years, leading to concerns about poor fetal development, preterm birth, and fetal distress. A recent study found a 16-fold increase in HCV prevalence among pregnant women from 1998 to 2018.
Despite the clear need for screening, research shows that only about 30% of perinatally exposed infants and children receive HCV testing. Reasons for this include the lack of awareness among pediatric providers regarding perinatal exposure, limited access to regular pediatric care for exposed children, and changes in healthcare providers before the recommended age for HCV testing at 18 months.
By initiating HCV testing at 2 months of age, experts believe that early detection and treatment can be more accessible, cost-effective, and potentially life-saving for infants and children exposed perinatally to HCV.
In conclusion, the newly updated CDC recommendations aim to address the rising rates of HCV among reproductive-age individuals and pregnant people. Early screening and diagnosis offer crucial opportunities for education, evaluation, curative treatment, and progress towards the goal of eliminating hepatitis C.
Frequently Asked Questions (FAQ)
Q: Can hepatitis C virus be transmitted through breastfeeding?
A: No, according to Hep Mag’s Health Basics on HCV, hep C is unlikely to be transmitted through breastfeeding or breast milk.
Q: How many Americans are estimated to be living with chronic HCV?
A: According to the CDC, approximately 2.4 million Americans, constituting around 1% of the adult population, were living with chronic HCV between 2013 and 2016.
Q: What are the risk factors for perinatal transmission of HCV?
A: The risk of perinatal transmission increases for women who are infected with HCV and have HIV, hepatitis B, or a high HCV viral load. However, the transmission risk does not significantly elevate through breastfeeding or breast milk.
Q: What are the updated recommendations for HCV screening in infants and children?
A: The newly issued recommendations include universal HCV screening between 2 to 6 months of age using a nucleic acid test, specialized care for those with detectable HCV RNA, and subsequent testing at 7 months and beyond for those who were not initially screened.
Q: Why is early detection and treatment of HCV important in infants and children?
A: Early detection and treatment of HCV in perinatally exposed infants and children offer opportunities for timely management, access to curative therapies, and progress towards the goal of eliminating hepatitis C.