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8.0 Antenatal and Perinatal Testing

Posted in: HCV

8.0 Antenatal and Perinatal Testing

8.1 Routine testing

Women contemplating pregnancy or seeking antenatal care should be made aware of the benefits of diagnosis of HCV infection and management and prevention strategies available for both the mother and the infant.

Antenatal testing must only be performed with informed consent of the woman. HCV testing must be offered in the context of appropriate risk assessment and discussion.46 Testing should be encouraged for those with clinical suspicion of infection (see section 3.0) and/or at risk of past infections (see section 3.1). There is a greater risk of a false positive anti-HCV result during pregnancy and HCV RNA testing should be used to confirm the HCV status of a person shown to be anti-HCV positive.

8.2 Testing of infants born to HCV-infected mothers

The risk of perinatal HCV transmission is 4% to 6%, and is two to threefold higher for mothers with HIV/HCV co-infection. Maternal antibodies may persist in an infant born to an HCV-positive mother for up to 18 months. Diagnosis of HCV infection in infants born to HCV-infected mothers is established by testing for HCV RNA. It is recommended that HCV RNA be tested at 8 weeks and again 4 to 6 weeks later to confirm ongoing infection and to exclude transient viraemia which can occur in infants. If the test returns positive on both occasions, the child should be referred to a Paediatric Gastroenterology or Infectious Diseases Unit for 6 monthly monitoring of liver function (this may require travel to a major centre where this service is available).

All children born to anti-HCV positive mothers should have antibody testing at 18 months of age because in rare instances transmission occurs from mothers with low and/or fluctuating HCV RNA levels and who test negative at the time of delivery. Where the mother’s RNA status is unknown at time of delivery it should be assumed to have been positive unless previous viral clearance has been demonstrated.

Quick links to resources on this page

ASHM: Antenatal testing and blood-borne viruses

Royal Australian and New Zealand College of Obstetricians and Gynaecologists: Hepatitis C

45. Australasian Society for HIV Medicine (ASHM). Antenatal testing and blood-borne viruses (BBVs). June 2011. Available at: http://www.ashm.org.au/images/pdfs/publications/1976963383_antenatal_web.pdf (Cited 23 March 2012).
46. Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG).
Hepatitis C (College statement: C-Gen 4). November 2009. Available at: http://www.ranzcog.edu.au/womens-health/statements-a-guidelines/collegestatements/487-hepatitis-c-c-gen-4.html (Cited 23 March 2012).

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Development of this site and the 2014 and 2017 revisions of the testing policies was supported by: Australian Government Department of Health and Ageing