Accuracy of HCV-RNA PCR tests for diagnosis or exclusion of vertically acquired HCV infection.
Polywka S, Pembrey L, Tovo PA, Newell ML.
Institute for Infectious Diseases, University Hospital Eppendorf, Martinistrasse, Hamburg, Germany.
The aim of the study was to estimate the sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and likelihood ratios for HCV-RNA PCR tests for the early diagnosis or exclusion of HCV infection in vertically exposed children. Data were included for children with confirmed HCV infection status from a European multi-center study. Confirmation was dependent on antibody status at or beyond 18 months, the 'gold standard' measure of infection status against which the use of qualitative HCV-RNA PCR tests was assessed. Of the 547 children included in this analysis, 193 were HCV-infected and 354 were not. Sensitivity of the HCV-RNA PCR test was low at birth (22%), but increased to 85% by 6 months. Specificity of RNA PCR was constant over age at 98%. The PPV of the PCR test rose from 33% at birth to 78% at 9 months of age, while NPV ranged from 96% to 99%. The high positive likelihood ratios from 1 month of age indicate strong evidence to diagnose infection but the negative likelihood ratios were consistent with weak evidence to exclude infection. The results suggest that the first qualitative HCV-RNA PCR test should be delayed until after the first month of life given the low sensitivity in the first few weeks. Although a negative test result after this time indicates probable absence of infection, this should be confirmed with a negative anti-HCV antibody test between 9 and 15 months of age as negative PCR results can be observed in infected children with fluctuations in viremia. Copyright 2005 Wiley-Liss, Inc.
http://www.ncbi.nlm.nih.gov/pubmed/16372293
Mike
There is nothing that compares to a mom's worries about her children. If you have insurance, or the cash to pay for it, you can do a viral load test on the baby much earluier than 18 months. That will give you the answer you are waiting for. It tests for the actual virus, not the antibody which all babies of hep C positive mom's are born with
I have two kids are both are negative and I definitely had hep when I was pregnant with them and so did my husband.
It is not likely either of your children will be positive. You can't have a bad case of hep c there is no such thing. You either have it or you don't. Nobody would ever advise you to terminate because of the slight risk - and even if your child should be positive it is not a death sentence or anything remotely like that. There are treatments that work and your child wouldn't have to do them for many, many years. By that time the treatments will be much much eaiser anyway - they are making HUGE strides in this field and by the time they might need to treat it could be quite a simple thing to deal with by that point.
Seriously - don't worry about this there are many more things to worry about in life and pregnancy rather than whether or not the child will test positive.
Please read through the following pages; these will give you a better understanding of what this is all about:
http://janis7hepc.com/Modes%20of%20Transmission.htm#moth
http://janis7hepc.com/Modes%20of%20Transmission.htm#preg
http://janis7hepc.com/Modes%20of%20Transmission.htm#Reducing Risk of Vertical Hepatitis
All the best to you an your family—
Bill
ok thanks heaps for all your help.i feel so alone i have no1 to talk to bout this.and no1 understands my feeling towards any of this,im trying not to stress i really am i thank u heaps for u taking the time to talk to me ,it means alot my husband knows but he doesnt understand he is not going thru this i am!he is woried about our son and the 1 on the way...and says i cant believe we have done this again ...another 18months we have to go thru hell..and he is so right but what bout how i feel doesnt it count...today got news 12 weekls ago my hepc has elevated,i have to do more test this week to see if they ok..im so worried about my baby too be,,i hope they dont say i have a bad case of hepc and i should terminate...im so confused thanks for listening to me just a bit depressed i guess;.]
Go to this link: http://digestive.niddk.nih.gov/ddiseases/pubs/hepc_ez/
aslo go to wikipedia and search for Hepatitis C
Everything will be alright you should not worry so much you are putting your liver into stress by so much worries which is very bad. Think of the fact that lots of people have this disease and they leave with it and they fight it and defeat it as well, there are so many people on this web-sit who cured Hep C.
The next thing you can do ... is educate yourself about your own Hep C and understand what your options are and understand your own condition well enough that you're doing what you need to for the mom of those kids.
Again...take care.
Trish
There is around a 5% chance that your child has Hep C so conversely, a 95% or less chance that they don't. There is nothing you can do about it now. You are simply going to have to tough it out and wait. You won't help your current 18 month old or the wee one you're now carrying by worrying yourself sick over something that you cannot do a darn thing about. It will be what it will be at this point, won't it.
What you need to focus on is taking good care of yourself and be the best mom you can be for those kids. Take things a step at a time. I hope it turns out well for you and if either of the kids turn out to be positive, then you'll deal and you'll help THEM deal.
Just focus on what's immediately in front of you - the rest you can take care of in it's own time.
Take care.
Trish
thanks heaps for your kind words,alot of people do tell me there is a a little chance that my son has it but it is stil one of the worst feelings in the world knowing my baby boy may have it,and im worried for the baby im having...i do take care of my self i dont drink or smoke i drink heaps of water ...salads and vegies every night...i just hope the results are all good...im very scared thats all..do u know some good info on the web i can read thru...as i dont know to much abpout it im trying to understand more for myself...
Do nto worry so much, there is very very little chace that Hep C will be transfered from mother to the child, so there is very big chance that your son is healthy, Ikonw a couple which has Hep C but their children are healthy so wait until the results and lets hope for the best.
Moreover Hep C is not a catastropha, you should take care of yourself do not drink alcohol at all and do not smoke, aslo avoid fatty food and eat more fruits and green vegetables. First of all take care of yourself as your child needs a healthy mother. Go to the doctor and he will give you more advice. As you can see lots of people have Hep C and they still leave a normal life. My husband also has this virus so we are keeping to a strict diet until we have enough money to start treatement. Search the web and learn as much as you can about this virus, you must become a specialist of your own illness.
I am sure that your child will be healthy, take care and inform us about the results too.