在美国,丙型肝炎病毒(HCV)感染的负担在包括孕妇在内的年轻人中不成比例地高,导致儿童感染增加,因为围产期传播仍然是儿童HCV感染的主要途径。因此,2020年,美国疾病控制和预防中心(CDC)建议在每次怀孕期间进行HCV筛查.婴儿期的HCV感染通常是无症状的,所以诊断完全依赖于对围产期暴露婴儿的检测,历史上,包括≥18月龄的抗HCV抗体检测.然而,全国围产期HCV检测率一直欠佳,随访损失显著。为了解决这个问题,2023年,CDC在2-6月龄时引入了早期单一HCVRNA检测,如果以前没有进行过检测,则可替代17月龄以下的HCVRNA检测.HCV实时PCR的高灵敏度和特异性为这一政策转变奠定了基础。在这篇综述中,我们强调了这些新的CDC建议将如何加强对婴儿和儿童的检测,并最终有助于整体消除HCV的努力。我们还强调了所有儿科提供者和产科医生在实施这些新指南中的作用。此外,我们为围产期暴露婴儿和儿童的测试提供我们的观点和实用建议。目前,用于HCV感染治疗的治疗性口服抗病毒药物被批准用于≥3岁的儿童.作为儿科医生,倡导儿童的健康,我们最大的责任是确保每个接触围产期丙型肝炎的儿童都经过检测,诊断,与护理有关,治疗,并实现了治愈。
In the US, the burden of hepatitis C virus (HCV) infection is disproportionately high among young adults including pregnant persons, resulting in increased infections among children as perinatal transmission remains the main route of HCV infection in children. Hence, in 2020, the Centers for Disease Control and Prevention (CDC) recommended universal HCV screening during each pregnancy. HCV infection in infancy is usually asymptomatic, so the diagnosis entirely relies on testing of perinatally-exposed infants which, historically, included anti-HCV antibody testing at ≥ 18 months of age. However, nation-wide perinatal HCV testing rates have been suboptimal with significant loss to follow up. To address this problem, in 2023, the CDC introduced early single HCV RNA testing at 2-6 months of age with an alternative for HCV RNA testing up to 17 months of age if not previously tested. The high sensitivity and specificity of the HCV real-time PCR laid the grounds for this policy shift. In this review we highlight how these new CDC recommendations will enhance testing of infants and children and ultimately contribute to overall HCV elimination efforts. We also emphasize the role of all pediatric providers and obstetricians in implementing these new guidelines. Additionally, we offer our perspective and practical advice for testing of perinatally exposed infants and children. Currently, curative oral antivirals for HCV-infection treatment are approved for children ≥ 3 years of age. As pediatricians, advocating for children\'s wellness, it is our utmost duty to ensure that every child exposed to perinatal hepatitis C has been tested, diagnosed, linked to care, treated, and achieved cure.