Children with hepatitis C may be unaware of their diagnosis and the potential need for treatments down the road to prevent long-term liver damage, shows a study by the Philadelphia Department of Health.
Using city surveillance data, the study found that as many as 8 in 10 children at high risk for hepatitis C exposure in Philadelphia were never screened for the condition. More specifically, of the approximately 500 moms-to-be who were registered as having hepatitis C between 2011 and 2013, only 84 of their newborns, or about 16 percent, were tested for the virus by 20 months of age.
‘Lack of drugs to prevent HCV transmission from mother to child, lack of screening during pregnancy pose as risk factors for the prevalence of Hepatitis C infection in adolescence.’
"Sixteen percent is really low," says Danica Kuncio, lead author of the study. "When you think about children, you hope that the number would be 100 percent, that it should be in the interest of every provider to be doing the best they can to get information to the next provider."
Kuncio, an epidemiologist with the city, worries that people who don't know they contracted hepatitis C as babies won't get the health care they need or realize they could spread the virus to others through blood-to-blood contact. It's a concern intensified by a rise in both injection drug use and hepatitis C among women of childbearing age, she said.
"It's a call to arms to figure out how we can do this better," said Dr. Michael Narkewicz, who specializes in pediatric liver diseases and hepatitis C at the University of Colorado School of Medicine.
Narkewicz and others say the next frontier is to prove that treatments are safe and effective in children. Clinical trials are underway, and he thinks the drugs could become available for children in the next year or two.
But unlike HIV, which has safe and effective treatments that can dramatically reduce transmission of the virus from mother to child, "for hepatitis C, there are no treatments to prevent transmission in a mom or in a newborn," said Narkewicz.
The medical community really hasn't done a good job of projecting the costs and benefits of early identification and treatment in children, according to Dr. Ravi Jhaveri, a pediatrician at UNC Children's Hospital in Chapel Hill, N.C.
Philadelphia's health department has begun working with health care providers and at-risk mothers in the city to improve the testing of infants born to women with hepatitis C, and when necessary, linking mother or child to specialists.