Pediatric Candidate Pre-Transplant HIV, HBV, and HCV Testing

At a glance

Current policy

Currently, transplant patients must be tested for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) while in the hospital for their transplant surgery. This testing, along with other required tests, may result in too much blood being drawn from low-weight pediatric patients right before their transplant surgery and may lead to medical complications.

Supporting media

Presentation

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Proposed changes

• Allow hospitals to test patients aged 10 years and younger for HIV, HBV, and HCV before they are admitted to the hospital for transplant.

Anticipated impact

• What it's expected to do
  • Reduce the risk of medical complications that can happen when too much blood is drawn from a patient at one time.
  • Allow hospitals to continue to safely monitor their pediatric patients for possible HIV, HBV, and HCV infections.
• What it won't do
  • Change the HIV, HBV, and HCV testing requirements for patients over the age of 11.

Terms to know

• Hepatitis B Virus (HBV): Formerly called serum hepatitis, it is caused by the hepatitis B virus (HBV). About 10 percent of cases progress to chronic hepatitis. It is spread through intravenous drug use, through sexual contact with infected individuals, through exposure to infected body fluids, and vertically from mother to child. Common symptoms include abdominal pain, fatigue, fever, jaundice, and elevated liver enzymes. A vaccine against HBV is available.
• Hepatitis C Virus (HCV): A form of hepatitis caused by the hepatitis C virus (HCV), previously known as non-A, non-B hepatitis. Most infections are due to injection drug use with contaminated needles. Blood transfusion-associated infections are rarer now than in the past due to improved blood donor screening. The CDC estimates 4.1 million (1.6 percent) Americans have been infected with HCV, of whom 3.2 million are chronically infected. Of the people who have chronic hepatitis C, 10 to 20 percent eventually develop cirrhosis and one to five percent develop hepatocellular carcinoma.
• Human Immunodeficiency Virus (HIV): The virus destroys cells in the immune system, which makes it difficult for the body to fight off infections; toxins, or poisons; and diseases. HIV causes AIDS, a late stage of the virus characterized by serious infections, malignancies and neurologic dysfunctions.

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