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July 28, 2021 01:06pm
By Jill Murphy, Associate Editor
Updated guidelines for hepatitis C virus provide new testing and management recommendations for pregnant women, individuals who inject drugs, men who have sex with men, and individuals who are incarcerated.
The hepatitis C virus (HCV) guidelines for unique populations have recently been updated. These guidelines provide new testing and management recommendations for pregnant women, individuals who inject drugs, men who have sex with men (MSM), and individuals who are incarcerated.
Managing HCV in Pregnancy
Approximately 29,000 HCV-infected women gave birth each year from 2011 to 2014.1The guidelines call for testing all pregnant women for HCV infection, especially at the initiation of prenatal care.1Women of reproductive age with known HCV infection should receive antiviral therapy before considering pregnancy to reduce the risk of mother-to-child transmission (MTCT), which is about 5-15%. Treatment during pregnancy is not recommended due to the lack of efficacy and safety data.
HCV in Individuals who Inject Drugs
Injection drug use is the most common risk factor for HCV infection in the United States and Europe.1All individuals who currently inject drugs or have injected drugs in the past should be tested for HCV infection. An HCV-antibody test should be used, and positive results should be confirmed by immediate HCV-RNA testing.
HCV in MSM
Annual HCV testing is recommended for sexually active HIV-infected adolescents, and adult MSM.1Acute HCV infections have been recently reported in HIV-uninfected MSM who present for pre-exposure prophylaxis (PrEP).1
HCV in Patients Who Are Incarcerated
The guidelines recommend HCV-antibody testing followed by HCV-RNA testing if antibody-positive.1Jails and prisons should encourage the continuation of HCV therapy for individuals receiving treatment at the time of incarceration. Individuals diagnosed with HCV while incarcerated should receive DAA therapy and substance use disorder treatment.
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