Table 1.

CDC and ACOG recommendations for screening

ACOG recommendations for HCV screening in pregnancy Source: ACOG Practice Bulletin 200711

Routine prenatal HCV screening is not recommended; however, women with significant risk factors for infection should be offered antibody screening.

CDC recommendations for HCV screening in general population Source: Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease (1998)12 and Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965 (2012)9

HCV testing is recommended for anyone at increased risk for HCV infection, including: Persons born from 1945 through 1965 Persons who have ever injected illegal drugs, including those who injected only once many years ago Recipients of clotting factor concentrates made before 1987 Recipients of blood transfusions or solid organ transplants before July 1992 Patients who have ever received long-term hemodialysis treatment Persons with known exposures to HCV, such as health care workers after needlesticks involving HCV-positive blood recipients of blood or organs from a donor who later tested HCV-positive All persons with HIV infection Patients with signs or symptoms of liver disease Children born to HCV-positive mothers

Testing of Uncertain Need Recipients of transplanted tissue (e.g., corneal, musculoskeletal, skin, ova, sperm). Intranasal cocaine and other noninjecting illegal drug users. Persons with a history of tattooing or body piercing. Persons with a history of multiple sex partners or sexually transmitted diseases. Long-term steady sex partners of HCV-positive persons.

The rationale for screening for HCV in pregnancy Identify children who will need to be tested – currently only 5–15% of infected children identified in US. Identify HCV infection in the mothers Pregnancy is one time when HCV-infected women may engage the health care system. Opportunity to treat after delivery--benefit long-term health of the mother and prevent risk of HCV infection in future pregnancies. In future may permit interventions to prevent MTCT.