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Updated: May 6, 2026
A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Hepatitis C Virus Testing Among Perinatally Exposed Children: 2018 to 2020
Kate R Woodworth1, Samantha Distler2, Daniel J Chang2
1Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities.
Insights
Hepatitis C virus (HCV) testing is low in perinatally exposed children, with only 50% tested by age 3. Improved provider education and public health resources are needed to enhance HCV testing and treatment in this vulnerable population.
Area of Science:
- Pediatric infectious diseases
- Hepatology
- Public health surveillance
Background:
- Perinatal exposure to hepatitis C virus (HCV) necessitates timely diagnosis and management in children.
- Early identification of HCV infection is crucial for preventing long-term liver disease and achieving HCV elimination goals.
Purpose of the Study:
- To evaluate the frequency and timing of HCV testing in a cohort of children exposed perinatally.
- To identify factors associated with receiving HCV testing by 2-3 years of age.
Main Methods:
- Analysis of a population-based surveillance cohort of perinatally exposed children (born 2018-2020) from four US jurisdictions.
- Data collection through electronic laboratory reporting, vital records, and medical records.
- Assessment of HCV testing frequency, timing, and type up to age 3 years.
Main Results:
- Among 615 children with available records, 50% received an HCV test by age 3.
- Most tested children (70%) received antibody testing at 18 months or later; 9% received nucleic acid testing by 6 months.
- No demographic or clinical factors were significantly associated with receiving an HCV test.
Conclusions:
- Significant gaps exist in current HCV testing protocols for perinatally exposed children.
- Enhanced provider education and public health department resources are essential for improving testing rates and linkage to care.
- Improved identification of infected children is a critical step towards HCV elimination.
Objective:
To assess the frequency of hepatitis C virus (HCV) testing among a population-based cohort of perinatally exposed children and identify factors associated with testing.
Methods:
Using a population-based surveillance cohort of perinatally exposed children born from 2018 to 2020 from 4 US jurisdictions (Georgia; Massachusetts; Allegheny County, Pennsylvania; and Los Angeles County, California), we describe the frequency, timing, and type of HCV testing among children and identify characteristics associated with having an HCV test result by the age of 2 to 3 years. Data were obtained from electronic laboratory reporting, vital records, and medical records.
Results:
Of 803 perinatally exposed children, 7 (1%) died before the age of 24 months. Of 796 children, health departments were unable to find medical records or laboratory reports for 181 (23%). Among those with medical record abstraction at 24 months or testing reported before the age of 3 years (n = 615), 50% had an HCV test. The majority (70% of those tested) were tested for HCV antibodies at the age of 18 months or later, although 9% had an HCV nucleic acid test at ages 2 to <6 months. No characteristics examined were found to be significantly associated with having testing reported.
Conclusions:
In this surveillance report, we identify the gaps in current testing among children perinatally exposed to hepatitis C. Provider education and resources for health departments for follow-up and linkage to care can improve the identification of children requiring treatment, a vital piece of HCV elimination.
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