TABLE 2. Perinatal HCV testing recommendations, by organization — United States, 2023.
| Organization | NAT for HCV RNA at age ≥2–6 months? | Confirm anti-HCV at age ≥18 months? | Anti-HCV with reflex* NAT for RNA at age ≥18 months? | Retest for HCV RNA before initiating treatment? | Test siblings? |
|---|---|---|---|---|---|
|
CDC
(2023)
|
Yes† |
No |
If not previously
tested |
Yes |
Yes |
|
AAP (2021 Red
Book)
§
|
Consider |
Yes |
Yes |
NA |
NA |
|
AASLD-IDSA
(2020)
¶
|
Consider** |
Yes |
Yes |
Yes |
Yes |
|
NASPGHAN
(2020)
††
|
Consider§§ |
NA |
Yes |
Yes |
Yes |
| AAFP (2010) ¶¶ | Yes*** | NA | Yes | NA | NA |
Abbreviations: AAFP = American Association of Family Physicians; AAP = American Academy of Pediatrics; AASLD = American Association for the Study of Liver Diseases; anti-HCV = hepatitis C virus antibody; HCV = hepatitis C virus; ISDA = Infectious Diseases Society of America; NASPGHAN = North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition; NA = not available; NAT = nucleic acid test; NIH = National Institutes of Health.
* NAT for HCV RNA performed on specimens that are anti-HCV reactive.
† NAT for HCV RNA can be done at age ≤17 months; at age ≥18 months, recommend anti-HCV testing with reflex to NAT for HCV RNA if not previously tested.
§ Source: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, editors. Red Book 2021–2024: report of the Committee on Infectious Diseases, 32nd edition. Itasca, IL: American Academy of Pediatrics; 2021.
¶ Source: Infectious Diseases Society of America. HCV in children. Arlington, VA: Infectious Diseases Society of America; 2022. Accessed June 2, 2022. https://www.hcvguidelines.org/unique-populations/children
** Consider at age 2–12 months.
†† Source: Leung DH, Squires JE, Jhaveri R, et al. Hepatitis C in 2020: a North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition position paper. J Pediatr Gastroenterol Nutr 2020;71:407–17.
§§ Consider at age 2 months if requested by family; recheck at age 12 months to confirm chronic hepatitis C.
¶¶ Source: Wilkins T, Malcolm JK, Raina D, Schade RR. Hepatitis C: diagnosis and treatment. Am Fam Physician 2010;81:1351–7.
*** AAFP recommendations based on a NIH consensus statement (now retired). These guidelines recommend a NAT for HCV RNA on two separate occasions between age 2–6 months or anti-HCV testing at age ≥15 months.