How are congenital hepatitis C virus infections diagnosed?

Updated: May 10, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD  more...
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Answer

Infants born to mothers with HCV infection deserve special consideration. [7] Definitive serology cannot be obtained until age 9-15 months. Most experts recommend waiting until after age 12 months to obtain antibody levels, with follow-up testing for any positives at that time.

Testing with real time PCR (RT-PCR) for HCV RNA is sensitive after the first 1-2 months of life; 95% of infants exposed will be uninfected and a negative result at this early point can be reassuring for the family. An argument can be made for not testing for HCV RNA because of cost considerations, however, and because even if the child is infected, treatment is rarely needed until the second decade of life.

Spontaneous clearance can occur (up to 30% of infected infants) but is rare beyond age 3 years. Children who clear infection are negative for HCV RNA but remain antibody-positive.


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