HCV in Pregnancy

Current US Centers for Disease Control and Prevention (CDC) screening guidelines (CDC, 1998); (Smith, 2012a) recommend that any woman—pregnant or otherwise—with a known or suspected risk factor, such as injection drug use or HIV infection, should be tested for HCV infection (see HCV Testing and Linkage to Care); (Koneru, 2016). Screening for HCV antibody should be followed by confirmatory nucleic acid testing (HCV RNA) for anyone positive on the screening assay (CDC, 2013) to differentiate past versus current, active infection. Women found to be HCV-infected should be linked to clinical care services for their infection(s) and for drug dependence treatment as needed. With current increases in HCV infection among young adults, including women of childbearing age, there is considerable discussion about the possibility of universal screening of pregnant women (Ly, 2017). Identifying HCV as women engage in prenatal care would allow appropriate assessment of liver disease status as well as establish care for their exposed children. This public health consideration will be weighed with concerns regarding potential cost and the logistics of linking patients to care.