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Guidelines Issued For The Screening Of Infants Born To Hepatitis C Virus-Positive Mothers

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  • claudine intexas
    DGReview Guidelines Issued For The Screening Of Infants Born To Hepatitis C Virus-Positive Mothers A DGReview of : Guidelines for the screening and follow-up
    Message 1 of 1 , Aug 13 7:53 PM
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      DGReview


      Guidelines Issued For The Screening Of Infants Born To Hepatitis C
      Virus-Positive Mothers
      A DGReview of :"Guidelines for the screening and follow-up of infants
      born to anti-HCV positive mothers"
      Digestive and Liver Disease

      08/07/2003
      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
      pediatric infection."

      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"


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