Guidelines Issued For The Screening Of Infants Born To Hepatitis C Virus-Positive Mothers
Guidelines Issued For The Screening Of Infants Born To Hepatitis C
A DGReview of :"Guidelines for the screening and follow-up of infants
born to anti-HCV positive mothers"
Digestive and Liver Disease
By Emma Hitt, PhD
New guidelines on the screening and follow up of infants born to
anti-hepatitis C virus (HCV) positive mothers have been issued by an
Italian medical organization.
Massimo Resti, MD, with the Department of Pediatrics, University of
Florence, Italy, and colleagues - on behalf of the Committee of
Hepatology of the Italian Society of Pediatric Gastroenterology and
Hepatology - note that issues regarding perinatal transmission are
still a matter of debate and may results in variable screening
practices among physicians.
"Although universal screening of pregnant women has not been
recommended - in particular circumstances suggestive of putative
exposure to HCV, maternal screening is desirable," they note.
According to the researchers, HCV infection in infancy for the most
part results from vertical transmission. "The transfer of HCV from
mother to child is almost invariably restricted to children whose
mother is viremic," they note "and the rate of transmission seems to
be influenced by maternal virus load, although, in the single
patient, the levels of viremia cannot be used as predictors of
Dr. Resti and colleagues recommend that in children born to mothers
who are anti-HCV antibody positive but RNA negative, alanine
aminotransferase and anti-HCV virus levels should be measured when
the child is 18 to 24 months of age. Then, if alanine
aminotransferase values are normal and anti-HCV is undetectable,
follow up is not necessary.
By comparison, in children whose mothers are HCV-RNA positive,
alanine aminotransferase and HCV RNA should be investigated when the
child is 3 months of age.
They make the following recommendations depending on the results of
the 3-month screen: "(1) HCV-RNA positive children should be
considered infected if viremia is confirmed by a second assay
performed within the 12th month; (2) HCV-RNA negative children with
abnormal alanine aminotransferase should be tested again for viremia
at 6-12 months, and for anti-HCV at 18 months; (3) HCV-RNA negative
children with normal alanine aminotransferase should be tested for
anti-HCV and alanine aminotransferase at 18-24 months, and should be
considered non-infected if alanine aminotransferase is normal and
anti-HCV undetectable; and (4) anti-HCV seropositivity beyond the
18th month in a never-viremic child with normal alanine
aminotransferase is likely consistent with past HCV infection."
Dig Liver Dis. 2003;35:7:453-457. "Guidelines for the screening and
follow-up of infants born to anti-HCV positive mothers"
Do you Yahoo!?
Yahoo! SiteBuilder - Free, easy-to-use web site design software