ANTENATAL AND PERINATAL TESTING

Routine Testing

Women contemplating pregnancy or seeking antenatal care should be made aware of the benefits of routine screening for hepatitis C and offered HCV (anti-HCV) antibody testing. People who are HCV antibody positive also need to be tested for HCV RNA because the small risk of perinatal transmission is conditional on the presence of maternal HCV RNA. Pre-natal hepatitis C testing provides the opportunity for counselling and treatment for those considering future pregnancies.⁸⁵

The risk of perinatal hepatitis C transmission is 4% to 6% and is 2- 3 fold higher for mothers with HIV/HCV co-infection.⁸⁶ 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 mothers with hepatitis C is therefore established by testing the child for HCV RNA. It is recommended that HCV-RNA testing of the infant occur from 8 weeks of age. This will enable early identification and early referral to a paediatric hepatology or infectious diseases clinic for appropriate follow up.^75,87

All children born to HCV antibody-positive mothers should have HCV antibody testing at 18 months of age because in rare instances vertical transmission occurs from mothers with low and fluctuating HCV RNA levels who test negative at the time of delivery.