消除丙型肝炎是国家优先事项 (https://www.hhs.gov/sites/default/files/Viral-Hepatitis-National-Strategic-Plan-2021-2025.pdf)。 2010-2021年间，美国丙型肝炎病毒（HCV）急慢性感染（以下简称HCV感染）有所增加，其后果包括肝硬化、肝癌和死亡。在此期间，育龄人群的急性感染率增加了两倍多（20-29岁人群中每10万人中有0.8人感染到2.5人，30-39岁人群中每10万人中有0.6人感染到3.5人）。由于急性丙型肝炎病毒感染可导致慢性感染，这导致妊娠期间丙型肝炎病毒感染率增加。大约 6%-7% 的围产期暴露（即怀孕或分娩期间暴露）的婴儿和儿童会感染 HCV。美国食品和药物管理局批准针对 3 岁以上人群进行有效的直接作用抗病毒治疗。然而，许多围产期感染的儿童没有接受检测或接受护理。 2020年，由于美国HCV感染持续增加，CDC发布了成人通用筛查建议，其中包括每次怀孕期间对孕妇进行筛查的建议（Schillie S、Wester C、Osborne M、Wesolowski L、Ryerson AB. CDC 对成人丙型肝炎筛查的建议 - 美国，2020 年。MMWR Recomm Rep 2020；69[No. RR-2]：1-17）。本报告介绍了 CDC 的四项新建议： 1) 对所有围产期暴露的婴儿进行 HCV 检测，并在 2-6 个月大时进行 HCV RNA 核酸检测 (NAT)； 2) 向具有儿科丙型肝炎管理专业知识的医疗保健提供者咨询，针对所有可检测到 HCV RNA 的婴儿和儿童； 3) 围产期暴露的婴儿和儿童在2个月或2个月后HCV RNA结果无法检测到，不需要进一步随访，除非临床需要； 4) 建议对以前未检测过的围产期暴露婴儿和 7-17 个月儿童进行 HCV RNA NAT，并进行丙型肝炎病毒抗体（抗 HCV）检测，然后进行 HCV RNA 反射 NAT（当抗 HCV 呈反应性）建议用于先前未接受过检测的 ≥ 18 个月的围产期暴露儿童。正确识别围产期感染儿童、转诊和治愈性治疗对于实现消除丙型肝炎的目标至关重要。

The elimination of hepatitis C is a national priority (https://www.hhs.gov/sites/default/files/Viral-Hepatitis-National-Strategic-Plan-2021-2025.pdf). During 2010-2021, hepatitis C virus (HCV) acute and chronic infections (hereinafter referred to as HCV infections) increased in the United States, consequences of which include cirrhosis, liver cancer, and death. Rates of acute infections more than tripled among reproductive-aged persons during this time (from 0.8 to 2.5 per 100,000 population among persons aged 20-29 years and from 0.6 to 3.5 among persons aged 30-39 years). Because acute HCV infection can lead to chronic infection, this has resulted in increasing rates of HCV infections during pregnancy. Approximately 6%-7% of perinatally exposed (i.e., exposed during pregnancy or delivery) infants and children will acquire HCV infection. Curative direct-acting antiviral therapy is approved by the Food and Drug Administration for persons aged ≥3 years. However, many perinatally infected children are not tested or linked to care. In 2020, because of continued increases in HCV infections in the United States, CDC released universal screening recommendations for adults, which included recommendations for screening for pregnant persons during each pregnancy (Schillie S, Wester C, Osborne M, Wesolowski L, Ryerson AB. CDC recommendations for hepatitis C screening among adults-United States, 2020. MMWR Recomm Rep 2020;69[No. RR-2]:1-17). This report introduces four new CDC recommendations: 1) HCV testing of all perinatally exposed infants with a nucleic acid test (NAT) for detection of HCV RNA at age 2-6 months; 2) consultation with a health care provider with expertise in pediatric hepatitis C management for all infants and children with detectable HCV RNA; 3) perinatally exposed infants and children with an undetectable HCV RNA result at or after age 2 months do not require further follow-up unless clinically warranted; and 4) a NAT for HCV RNA is recommended for perinatally exposed infants and children aged 7-17 months who previously have not been tested, and a hepatitis C virus antibody (anti-HCV) test followed by a reflex NAT for HCV RNA (when anti-HCV is reactive) is recommended for perinatally exposed children aged ≥18 months who previously have not been tested. Proper identification of perinatally infected children, referral to care, and curative treatment are critical to achieving the goal of hepatitis C elimination.