As noted earlier, a mother with hepatitis C can pass HCV on to her child, though this is not common. If your doctor suspects that your child may have hepatitis C, he or she may order a blood test to see whether your child’s blood contains antibody against HCV. Antibodies are proteins produced by the immune system in response to infections from viruses, bacteria, and other harmful organisms. In the case of HCV, the antibody is not “protective” (that is, it does not make your child immune to or safe from the virus) but rather simply indicates that your child has been exposed to HCV.
The antibody test can be confused by the fact that children younger than 18 months often still carry antibodies from their mother in their blood; these maternal antibodies can mask the presence of antibodies produced by the child’s own immune system, or they may make it appear like the child is infected when he or she is not. For this reason, your doctor may hold off on testing your child until he or she reaches 18 months of age.
The antibody test can only tell doctors if your child has been exposed to HCV at some point in his or her life, not whether he or she is currently infected with it. To do that, your doctor will order an additional test, this time for the virus itself. This test can be carried out at a younger age than the antibody test, though it is most accurate if your child is older than 6 months. However, since some babies will go on to the clear the virus by age 3, your child’s doctor may defer testing until that age.
There are six major genetic types, or genotypes, of the virus, each of which responds differently to treatment. Different genotypes are more common in different parts of the world; most cases of hepatitis C in the United States, for instance, can be traced to infection with HCV genotype 1. To decide on the best course of action, your doctor will conduct one more test, this time to see which genotype of the virus your child is carrying. With this information in hand, your doctor can then recommend the best treatment plan for your child.
Your doctor may also discuss ordering a liver biopsy to see whether the virus has started to cause your child’s liver to scar, and if so how much. Should your child have chronic hepatitis C, he or she will also need to have periodic liver tests to look for any signs of chronic liver disease.