Abstract We describe hepatitis C testing of 47 (2%) of 2,266 children diagnosed with perinatal hepatitis C who were exposed during 2018–2020 in 7 jurisdictions in the United States. Expected frequency of perinatal transmission is 5.8%, indicating only one third of the cases in this cohort were reported to public health authorities. Hepatitis C virus (HCV) can be transmitted perinatally ( 1 ). Rates of acute HCV infection have increased recently ( 2 ), but few children perinatally exposed to HCV are tested and referred to care ( 3 ). As of November 2023, the Centers for Disease Control and Prevention recommends testing of all perinatally exposed infants for detection of HCV RNA at age 2–6 months, which is earlier than previous recommendations of ≥18 months of age for HCV antibody testing ( 4 ). There may be advantages to performing HCV RNA testing earlier, before children might become lost to follow-up ( 5 ). A prior analysis found only 16% of children perinatally exposed to hepatitis C in Philadelphia, Pennsylvania, USA, received HCV testing ( 6 ). Limited data are available from larger surveillance cohorts about current testing patterns of children perinatally exposed to HCV. Positive HCV test results are nationally notifiable in the United States, but negative HCV test results are not. To identify potential gaps in testing and surveillance, we used positive HCV test results to describe testing and frequency of children diagnosed with perinatal hepatitis C during 2018–2020 compared with the expected frequency of perinatal transmission in 7 US jurisdictions. This activity was deemed as public health surveillance and not research at Centers for Disease Control and Prevention, thus exempt from institutional review board review. We assembled a retrospective cohort from surveillance data of pregnant women. The exposure of interest was prenatal exposure to HCV, […]
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