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The silent infection: should we be testing for perinatal hepatitis C and, if so, how?

Winita Hardikar, Elizabeth J Elliott and Cheryl A Jones
Med J Aust 2006; 184 (2): 54-55.

We recommend screening all infants whose mothers are HCV antibody-positive

Perinatal transmission of hepatitis C virus (HCV) is the main source of newly diagnosed paediatric HCV infections in Australia.1 About 5% of infants born to women who are positive for both HCV antibody and HCV RNA during pregnancy will acquire HCV infection.2 The risk of transmission is increased by HIV coinfection during pregnancy. It is estimated that 1%–2% of women of childbearing age in Australia are infected with HCV.3 Assuming that 75% of these have chronic hepatitis and viraemia in the third trimester of pregnancy, we would expect about 75–100 new cases of vertically acquired childhood HCV infection in Australia per year. However, rates reported from national deidentified laboratory data4 and from the Australian Paediatric Surveillance Unit1 are much lower, suggesting that paediatric HCV infection may be underrecognised in Australia. We thus recommend a more standardised approach to identification and follow-up of infants exposed perinatally to HCV.

  • Winita Hardikar1
  • Elizabeth J Elliott2
  • Cheryl A Jones3

  • 1 Royal Children's Hospital, Melbourne, VIC.
  • 2 University of Sydney and The Children's Hospital at Westmead, Sydney, NSW.

Correspondence: 

Acknowledgements: 

We thank the other members of the Australian Paediatric Surveillance Unit (APSU) Hepatitis C Study team, in particular Ms Sue Polis, Associate Professor Greg Dore and Professor John Kaldor (National Centre for HIV and Hepatitis C Epidemiology and Clinical Research [NCHECR]) for their valuable comments, and the contributors to the APSU. The APSU Hepatitis C study is funded by the NCHECR and the Department of Health and Ageing.

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