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Re: Hepatitis C testingFrom: Anna Meenan, MD (annam@uic.edu)Thu Aug 26 14:00:27 1999
At Thu, 26 Aug 1999, Ronald E. Ainsworth wrote: > >Hepatitis C has become a very significant problem in the 90's and from >what I see, recommendations on management and testing are inthe >developmental stage. For the last several years, I have offered Hep C >Ab testing in patients who request or need STD testing. Is that >everyone's practice now, and are there any practice guidelines that you >are aware of from ACOG, Planned Parenthood or other "authorities" to >support that? Are you offering Hepatitis C testing to New Ob patients >who have the usual risk factors (IV drug use, partner with Hep C or IV >drug user, history of blood transfusions prior to routine screening)? >How about NOBs with tattos or body piercing, but no other risk factors? > >-- >Ronald E. Ainsworth, MD, FACOG >Paradise, CA, Private Practice 20 yrs. > Screening should be offered to all patients, male or female, pregnant or non-pregnant, who report a history that puts them at risk for Hep C. These include IV drug use, transfusion before 1992, intranasal cocaine use, multiple sex partners, hemodialysis, needle-stick injuries, history of other STD's, extensive body piercing, tattoos, or having been in prison. I'm not aware of any research on specific interventions to keep the infant from acquiring the infection if mom is positive. The newest ACOG Committee Opinion on breastfeeding and the risk of transmission says the rate of infection for infants born to women who are HCV positive but HIV negative is 5-6%, but I don't think we have any way of modifying that. Have not seen anything on the use of interferon/ribavirin in pregnancy. Breastfeeding, by the way, according to ACOG, does not appear to be a mode of transmission, as 4% of both breast-fed and bottle-fed infants acquire the virus during infancy if mom is positive.
-- Anna Meenan, MD
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