CDC recommends testing all children exposed to hepatitis C

Key points:

• In new guidelines, the CDC recommends testing all infants and children who are perinatally exposed to hepatitis C.
• This includes children over 18 months who have never been tested.

The Centers for Disease Control and Prevention this week recommended hepatitis C testing for all infants or children who were exposed to hepatitis C virus during the perinatal period from pregnant women with current or possible hepatitis C infection.

write on millimeter wave ratio, The authors of the recommendations defined current HCV infection as anyone with detectable HCV RNA and probable infection as anyone who had a reactive anti-HCV test but for whom HCV RNA results were unavailable.

As the authors outline new recommendations in millimeter wave radaras described below:

• Perinatally exposed infants should undergo HCV RNA nucleic acid testing (NAT) at 2 to 6 months of age to identify children who may develop chronic HCV infection if left untreated.
• Infants with detectable HCV RNA should be managed in consultation with a healthcare provider with expertise in pediatric hepatitis C management.
• Infants with undetectable HCV RNA results do not require further follow-up unless clinically warranted.
• Infants and children 7 to 17 months of age who were perinatally exposed to HCV and have not been previously tested should receive HCV RNA NAT.
• Children 18 months or older who were perinatally exposed to HCV and have not been previously tested should undergo anti-HCV testing with reflex detection of NAT for HCV RNA.

We spoke to the experts Lynn Yee, MD, maternal-fetal medicine specialist and director of Northwestern Medicine’s Women’s Infectious Diseases Program, and Ravi Jhaveri, MD, Chief of Infectious Diseases at Lurie Children’s Hospital in Chicago on new guidelines and risks associated with hepatitis C virus infection during pregnancy.

Lin Yi

Helio: Suppliers may not be aware of the following risks Hepatitis C virus during pregnancy. What are the health effects?

Yi: In addition to the risks of HCV that everyone experiences (such as liver fibrosis, cirrhosis, and cancer), there are some risks that are specific to pregnancy. First, there is an association between HCV and an increased risk of preterm birth, intrahepatic cholestasis of pregnancy, and insufficient fetal growth. Additionally, there are some studies suggesting an increased risk of gestational diabetes, although this is not yet clear. Second, the risk of HCV transmission to fetuses and newborns is 5% to 15%, posing a potential lifelong risk to children, especially if it goes unrecognized.

Helio: What are the biggest changes the CDC recommends?arriveWhat’s the biggest development since the last update?

Javeri: By emphasizing early detection of HCV-exposed infants, we hope to test more infants when they visit the doctor for vaccinations and well-child checkups. Elimination of the previously existing long delay (18 months) should help minimize the number of infants lost to follow-up.

Helio: Can you elaborate on the testing options for hepatitis C during pregnancy?

Yi: According to the 2020 U.S. Preventive Services Task Force guidelines, it is now recommended that all pregnant women receive HCV antibody testing during routine prenatal care. The test is typically performed at a baseline prenatal lab and also tests for HIV, blood type, rubella immunity and diet, among other things. If antibodies are found to be present, further tests are done to investigate the presence of the virus in the blood and to assess liver function.

Helio: Where do you think these recommendations fall short?

Javeri: The recommendations are clear, but we still need to help pediatricians and other pediatric providers deal with the logistics of how to administer this test in their offices. These strategic issues need to be addressed for practices and groups caring for these infants.

We need better coordination between pregnancy care providers and pediatric providers to ensure that parent-child death information is shared between them. This is crucial to help improve the situation.

Helio: Why it’s so important to include pregnant patients in research Hepatitis C virus?

Yi: Including pregnant women in research programs about any condition or treatment is critical to optimizing the health of pregnant women and their families—without research to build evidence for new medicines, pregnant women are left behind when medicine advances. As we learned in the early stages of the COVID-19 pandemic, when pregnant women were excluded from SARS-CoV-2 vaccine trials, excluding pregnant women deprived doctors and patients of the information they needed to safely and comprehensively care for us. patient.

Specific to HCV, treatment of nonpregnant persons is the standard of care, and inclusion of pregnant persons in treatment and research programs is necessary to achieve the public health goal of eliminating HCV. Additionally, pregnant women should have autonomy and the right to make informed decisions about their health, which for some may include receiving HCV treatment during pregnancy.

refer to:

Panagiotakopoulos L et al. millimeter wave radar Mob mortal weekly represent. 2023;doi:10.15585/mmwr.rr7204a1.

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