Physician: Positive Test for Hepatitis C on the Adoption Medical Abstract

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Hepatitis C is a liver disease caused by infection with the hepatitis C virus. The virus causes liver inflammation, which interferes with proper liver function. It can eventually lead to severe, permanent liver damage and cirrhosis and may be complicated by liver cancer. Because the initial symptoms are mild, hepatitis C often goes unnoticed until years later when liver damage is discovered. Maternal-infant transmission is not common. In most studies, only 5 percent of infants born to infected women become infected. The disease in newborns is usually mild and free of symptoms. The risk of maternal-infant spread rises with the amount of virus in the mother's blood. Breast-feeding has not been linked to HCV's spread.

Hepatitis C viral tests detect substances in the blood that indicate a hepatitis infection is active, chronic, or has occurred in the past. The tests detect proteins (antibodies) or genetic material (DNA or RNA) of the virus that causes hepatitis. It is important to identify the type of hepatitis virus causing infection so that its spread can be prevented and the proper treatment can be started immediately. Anti-HCV antibody tests detect the presence of antibodies to HCV in the blood, indicating an HCV infection has occurred. However, this test makes no distinction between an acute or chronic infection.

The enzyme immunoassay (EIA) may be the first test done to detect anti-HCV antibodies. Sometimes a supplemental test called the recombinant immunoblot assay (RIBA) may be done to confirm a positive EIA test result. This test can tell whether a positive result was from an actual HCV infection or whether the result was a false-positive.

HCV genetic material (RNA) testing uses polymerase chain reaction (PCR) to detect the RNA of an active hepatitis C infection. The RNA can be detected in a person's blood within 1 to 2 weeks after exposure to the virus. HCV RNA testing may be done to confirm a positive result on an HCV antibody test, define the level of virus in the blood (called viral load), or predict the likelihood that a person with HCV will respond to medical treatment. Another RNA test called genotyping can define the strain of hepatitis C and indicate how likely it is to respond to treatment.

HCV quantitative test or viral load is often used before and during treatment to determine how long treatment needs to be given and to monitor your response to treatment. HCV viral genotyping is used to determine which genotype of the HCV virus is present. HCV has 6 genotypes, and some are more responsive to treatment than others. There is no preventive vaccine available for Hepatitis C. It is recommended that all children at risk for Hepatitis C be immunized for both Hepatitis A and B.

by Nicholas Rogu, M.D.

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The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.

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