II. Indications: Screening in pregnant women

  1. See Hepatitis C for risk factors

III. Pathophysiology

  1. Vertical transmission Risk
    1. Mother HCV Ab positive and HCV RNA negative: 1.7% vertical transmission rate of HCV
    2. Mother HCV Ab Positive and HCV RNA positive: 4.3% vertical transmission rate of HCV
    3. Mother HCV Ab Positive and Comorbid HIV positive: 19.4% vertical transmission rate of HCV

IV. Labs: Diagnosis of Hepatitis C in infant

  1. Initial false positive testing due to persists maternal HCV antibodies in infant for upwards of one year
  2. Diagnostic criteria
    1. HCV RNA positive on each of 2 samples from infant between age 2 and 6 months
    2. Absent HCV Antibody after 15 months suggests infant is HCV negative

V. Management: HCV positive mother

  1. Gastroenterology referral for Hepatitis C infected mother
  2. Interferon and Ribavirin protocol contraindicated in pregnancy (Ribavirin is Teratogenic)

VI. Management: Infant

  1. Factors that do not impact transmission
    1. Ceserean section does not reduce transmission
    2. Breast Feeding does not increase transmission rate

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