Diagnosis And Management Of Hepatitis C Infection In Infants, Children, And Adolescents
Publication Date: June 1, 2012
Last Updated: March 14, 2022
Recommendations
Anticipatory guidance and screening
Household contacts
No contraindication
Sharing food, drink, eating utensils, clothes, towels, laundry, toilet seats (Strong, High, A, III)
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Avoid
Sharing toothbrush, shaving equipment, nail clippers, tweezers, glucometers, or other personal item that may be contaminated with blood. (, , , )
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Routine screening
Not recommended (Weak, Moderate, B, III)
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Nonhousehold contacts
No contraindication
Attending day care, school, camps, playgrounds, play dates, community pools; participating in contact and non-contact sports
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Avoid
Sharing toothbrush, shaving equipment, nail clippers, tweezers, glucometers, or other personal item that may be contaminated with blood. (, , , )
N.A.
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Routine screening
Not recommended (Weak, Moderate, B, III)
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Casual contacts
No contraindication
Kissing, hugging, holding hands (-)
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Avoid
N.A.
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Routine screening
Not recommended (Weak, Moderate, B, III)
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Sexual contacts
No contraindication
Monogamous sexual contact (-)
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Avoid
Unprotected sexual activity with multiple partners (-)
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Routine screening
Not recommended: monogamous relations (Weak, Moderate, B, III)
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Recommended: polygamous relations (Weak, Moderate, B, III)
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Other activities
No contraindication
N.A.
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Avoid
Tattooing, body piercing (-)
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Routine screening
N.A.
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N.A..not applicable.
Special considerations for pediatric HCV infection
Blood spills (including dried blood)
Thoroughly clean spill area using a dilution of 1 part household bleach to 10 parts water. Gloves should be worn when cleaning up blood spills (refer to www.CDC.gov). (-)
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Minor cuts or bruises
Observe universal precautions. (-)
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Use of over-the-counter analgesia, anti-inflammatory and antipyretics
- Occasional use is acceptable. NSAIDs should be avoided in those with varices.
- Short intermittent courses of corticosteroids such as for asthma are acceptable.
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Vaccinations
Should receive all of the age-appropriate immunizations, including hepatitis A and hepatitis B vaccines. (Strong, High, A, I*)
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Obesity
Obesity may further burden liver health and negatively influence response to HCV therapy.
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Exercise
No restrictions to school and sports.
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Alcohol consumption
Avoid alcohol consumption because it strongly correlates with rapid progression of liver disease.
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Illicit drug use (nasal cocaine, intravenous agents).
Avoid high-risk behaviors that will promote HCV reinfection (posttreatment) and transmission of other viruses. (-)
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Pregnancy
Because there are presently no effective strategies to prevent perinatal HCV transmission, universal screening of pregnant women is not recommended. (-)
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Obstetrical-perinatal factors
Vertical transmission of HCV is similar between infants born by C-section or vaginally. However, prolonged rupture of membranes and the use of fetal scalp probes are associated with increased HCV transmission rates and should be avoided. (Strong, Moderate, A, II)
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Postnatal period
The rate of vertical transmission is similar between breast- and bottle-fed infants. Hence, breast-feeding is not generally contraindicated in mothers with HCV infection. Breast-feeding should be avoided if there is mastitis or bleeding. (Strong, Moderate, A, II)
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Recommendations for monitoring during therapy
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| Laboratory test to be monitored | Obtain test on following wk of therapy |
| CBC with differential, absolute neutrophil count | 0, 1, 2, 4, 8, 12 and every 4–8 wk thereafter |
| Hepatic panel, glucose | 0, 1, 2, 4, 8, 12 and every 4–8 wk thereafter |
| TSH/total T4 | 0, 12, 24, 36, 48 |
| Urine HCG (for female patients 13 y or older) | 0, 24 |
| Prothrombin time | 0; only repeat if clinically indicated |
| Urinalysis | 0; only repeat if clinically indicated |
| HCV RNA | 0, 24, 48, 72 |
| CBC.complete blood cell; HCG.human chorionic gonadotropin; HCV.hepatitis C virus; TSH.thyroid-stimulating hormone. | |
Recommendation Grading
Overview
Title
Diagnosis And Management Of Hepatitis C Infection In Infants, Children, And Adolescents
Authoring Organization
Consensus and Physician Experts
Publication Month/Year
June 1, 2012
Last Updated Month/Year
January 8, 2024
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Child, Infant
Health Care Settings
Ambulatory
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Diagnosis, Management, Treatment
Diseases/Conditions (MeSH)
D008107 - Liver Diseases
Keywords
chronic hepititis, infectious hepititis, interferon therapy, pediatric liver disease