Dear Colleague:
There has been a sharp increase in Hep C infections in people of childbearing age in the United States in the last several years and a resultant increase in perinatal Hep C transmission.
In 2020, the United States Preventive Services Task Force and the Centers for Disease Control and Prevention recommended universal screening for Hep C during each pregnancy. Screening for hepatitis C during pregnancy will result in earlier diagnosis among those who were not aware they were infected. As a result, providers can: 1) provide education, supportive services, and guidance on how the patient can prevent transmission to others; 2) discuss ways to decrease the risk of associated pregnancy complications and transmission of the virus to the baby; and 3) facilitate treatment initiation. All people can be treated for Hep C , including people who are living with HIV or who have other comorbidities, as well as people who use alcohol or drugs.
Children who have been exposed to Hep C perinatally should be tested. The American Association for the Study of Liver Diseases and Infectious Diseases Society of America recommends testing perinatally exposed children at 18 months with a Hep C antibody test. Children can also be screened between 2 to 18 months with a Hep C virus ribonucleic acid (RNA) test. Children can be treated for hepatitis C at age 3 years.
To improve health outcomes of pregnant people and their children at risk for Hep C :
- Test all pregnant patients for Hep C during each pregnancy. If positive, refer to a liver specialist to assess liver health and provide hepatitis C treatment.
- Test children born to a person with Hep C. For children aged 2 to 18 months, conduct a hepatitis C RNA test. For children aged 18 months or older, use a Hep C antibody with reflex to RNA confirmatory test. If positive for hepatitis C RNA, refer to a pediatric hepatologist for monitoring and treatment.
For referrals for hepatitis treatment, visit www.nyc.gov/health/hepC or email hep@health.nyc.gov
Resources
American Association for the Study of Liver Diseases and Infectious Diseases Society of America
– Hepatitis C Practice Guidelines:
- Hep C in Pregnancy: www.hcvguidelines.org/unique-populations/pregnancy
- Hep C in Children: www.hcvguidelines.org/unique-populations/children
- Simplified Hep C Treatment for Treatment-Naive Adults Without Cirrhosis: www.hcvguidelines.org/treatment-naive/simplified-treatment
- United States Preventive Services Task Force Screening Recommendations for Adolescents and Adults: www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening
- FDA-Approved Hep C Treatment for Pediatric Patients: www.fda.gov/news-events/pressannouncements/fda-approves-new-treatment-pediatric-patients-any-strain-hepatitis-c
- Centers for Disease Control and Prevention Perinatal Hep C Information: www.cdc.gov/nchhstp/pregnancy/challenges/hcv.html
- New York State Department of Health Hep C Clinical Guidelines on Pregnancy: www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4
– Hepatitis Clinical Training:
- Clinical Education Initiative: www.CEITraining.org
- Empire Liver Foundation: www.empireliverfoundation.org
- Clinical Care Options: www.clinicaloptions.com/hepatitis
– New York City Health Department:
- Hepatitis Information: www.nyc.gov/health/hepatitis
- Testing and Treatment Site Locator: https://a816-healthpsi.nyc.gov/NYCHealthMap
- For support with screening, treatment, or finding a referral, email hep@health.nyc.gov
Sincerely,
Marcelle Layton, MD
Assistant Commissioner
Bureau of Communicable Disease
Last Updated on July 24, 2023 by HepFree NYC
