Hepatitis C

Question 1

Do you recommend universal screening for hepatitis C in pregnancy?

Answer 1

ACOG recommends screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection is less than 0.1%.

Question 2

Who should be screened for hepatitis C infection in pregnancy?

Answer 2

CDC

• all adults aged 18 years and older, except in settings where the prevalence of HCV infection is less than 0.1%.
• all with risk factors
• each pregnancy, except in settings where the prevalence of HCV infection is less than 0.1%

USPSTF

• adults aged 18 to 79 years
• younger than 18 years and older than 79 years who are at high risk for infection (eg, those with past or current drug use).
• Pregnancy
• younger than age 18 years.

Question 3

How do you counsel a pregnant patient with a positive hepatitis C antibody?

Answer 3

A reactive or positive antibody test means you have been infected with the hepatitis C virus at some point in time

Question 4

What is your initial workup for a patient with a positive hepatitis C antibody?

Answer 4

nucleic acid test (NAT) for HCV RNA

Question 5

How is hepatitis C transmitted?

Answer 5

contact with blood from an infected person

• sharing drug-injection equipment
• birth
• healthcare exposures
• sex with an infected person
• unregulated tattoos or body piercings
• Sharing personal items.
• blood transfusions and organ transplants.

Question 6

What is the likelihood of vertical transmission in a patient with hepatitis C infection?

Answer 6

5.8-10.8%

Question 7

What is the role of hepatitis C viral load and risk of vertical transmission?

Answer 7

Unknown

Question 8

Can a patient with hepatitis C infection breastfeed?

Answer 8

Yes

Question 9

How should a neonate born to a hepatitis C infected mother be managed?

Answer 9

screening of infants born to HCV-positive women for antiHCV antibodies >18 months of age or for HCV RNA on 2 occasions in infants >1 month of age.

Question 10

Is cesarean delivery recommended for patients with high hepatitis C viral loads?

Answer 10

No

Question 11

What are maternal risks of chronic hepatitis C infection?

Answer 11

Gestational diabetes
Preeclampsia
Miscarriage
Hepatocellular damage
Liver fibrosis

Question 12

Can you treat hepatitis C in pregnancy?

Answer 12

No