Recent advances in hepatitis C virus (HCV) care have prompted a shift toward earlier screening and treatment for pregnant persons and children. Despite the known risk of vertical transmission and the availability of curative treatment for children as young as three, screening rates among infants exposed to HCV in utero remain low in Canada. To address this, major US organizations including the Centers for Disease Control and Prevention, American Association for the Study of Liver Diseases, and Infectious Disease Society of America now recommend HCV RNA testing at 2 to 6 months of age—rather than the traditional 18-month antibody test—to improve diagnosis and linkage to care. While Canada currently lacks updated national guidelines, the data strongly support earlier infant testing and integration into standard pediatric care, such as the Rourke Baby Record, to prevent missed diagnoses and long-term complications.

Universal HCV screening in pregnancy is also gaining traction as a key intervention. With rising HCV prevalence among people of childbearing age and vertical transmission rates of 5% to 6%, pregnancy offers a critical opportunity to diagnose and plan for postpartum treatment. Emerging research suggests treatment during pregnancy may be both safe and effective, leading to updated US recommendations for case-by-case consideration. Together, these shifts support a more proactive, prevention-focused approach to HCV elimination in Canada—one that prioritizes early screening, timely treatment, and reduced stigma for mothers and children alike.

Reference: Biondi MJ, Flemming J, van Gennip J, et al. Hepatitis C virus testing in infants: a move to early screening by HCV RNA at 2 months of age. Paediatr Child Health. 2025;pxaf012. doi:10.1093/pch/pxaf012.