Neonatal HCV

Background

Epidemiology

• About 5% risk of vertical transmission, though higher if coinfected with HIV
  • About half are transmitted antepartum and half intrapartum

Clinical Manifestations

• Asymptomatic, usually for decades, before slowly progressive liver disease

Management

• Management in adults

Perinatal Exposure

• Not urgent, as it is a chronic illness that may not manifest for decades
• Serology to be done at 12-18 months for diagnosis
• If significant anxiety, can send HCV-PCR at 3 to 6 months
  • 25-30% will spontaneous clear it
  • Still need serology at 12-18 months, and repeat PCR around 18 months