II. Indications: Screening in pregnant women
- See Hepatitis C for risk factors
III. Pathophysiology
- Vertical transmission Risk
- Mother HCV Ab positive and HCV RNA negative: 1.7% vertical transmission rate of HCV
- Mother HCV Ab Positive and HCV RNA positive: 4.3% vertical transmission rate of HCV
- Mother HCV Ab Positive and Comorbid HIV positive: 19.4% vertical transmission rate of HCV
IV. Labs: Diagnosis of Hepatitis C in infant
- Initial False Positive testing due to persists maternal HCV antibodies in infant for upwards of one year
- Diagnostic criteria
- HCV RNA positive on each of 2 samples from infant between age 2 and 6 months
- Absent HCV Antibody after 15 months suggests infant is HCV negative
V. Management: HCV positive mother
- Gastroenterology referral for Hepatitis C infected mother
- Interferon and Ribavirin protocol contraindicated in pregnancy (Ribavirin is Teratogenic)
VI. Management: Infant
- Factors that do not impact transmission
- Ceserean section does not reduce transmission
- Breast Feeding does not increase transmission rate