There has been a sharp increase in hepatitis C infections in people of childbearing age in the United States
in the last several years and a resultant increase in perinatal hepatitis C transmission.
In 2020, the United States Preventive Services Task Force and the Centers for Disease Control and Prevention recommended universal screening for hepatitis 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 hepatitis 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 hepatitis 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 hepatitis C antibody test. Children can also be screened between 2 to 18 months with a hepatitis 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 hepatitis C:
– Test all pregnant patients for hepatitis 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 hepatitis C. For children aged 2 to 18 months, conduct a hepatitis C RNA test. For children aged 18 months or older, use a hepatitis C antibody with reflex to RNA confirmatory test. If positive for hepatitis C RNA, refer to a pediatric hepatologist for monitoring and treatment.
American Association for the Study of Liver Diseases and Infectious Diseases Society of America
Hepatitis C Practice Guidelines:
– Hepatitis C in Pregnancy: www.hcvguidelines.org/unique-populations/pregnancy
– Hepatitis C in Children: www.hcvguidelines.org/unique-populations/children
– Simplified Hepatitis 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 Hepatitis 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 Hepatitis C Information: www.cdc.gov/nchhstp/pregnancy/challenges/hcv.html
– New York State Department of Health Hepatitis C Clinical Guidelines on Pregnancy: www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4
– Hepatitis Clinical Training:
-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 firstname.lastname@example.org
Marcelle Layton, MD
Bureau of Communicable Disease