tests, and it makes sense to consider that the higher the viral load, the higher the degree of infectivity. Treatments Antiviral treatments are available for the treatment of hepatitis C infection and are variably beneficial. Such treatments are not currently available during pregnancy or licensed in young infants. There is little experience in treating children with antivirus drugs. For this reason, routine testing of pregnant women is not recommended, but may be in the future. The transmission of antibody from mother to baby gives rise to a positive test in new-borns of mothers with hepatitis C antibodies but this does not necessarily indicate the presence of virus or active infection so much as the presence of maternal antibodies. The presence of active infection should be sought later in the first year of life. In those with active infection or ongoing illness, the specialist treatment of hepatitis C is increasingly effective. Treatment with Interferon, Ribavirin, or a combination of drugs is complicated and expensive and may require drugs by injection, but can be effective in excluding the virus from the body and possibly effecting long-term cure. This is likely to be increasingly available. is now a wide range of treatments, including many antiviral drugs, available for management of HIV infection. These drugs can be given during pregnancy so women already on treatment before they become pregnant can continue their medication throughout pregnancy. Treatment with antivirals will also reduce vertical transmission, therefore women who are not already receiving treatment should be offered treatment during pregnancy. Treatment given to the mother to prevent vertical transmission can be discontinued at delivery if she wishes, but the baby should then receive treatment for the first few weeks of life. Delivery by elective Caesarean section has also been shown to reduce vertical transmission. 6.9 Appendix 9 Impact of Mental Health Although most parents with psychiatric problems are able to care for children appropriately research has indicated that child-maltreating parents are often shown to have mental health problems. Non-compliance with medication without medical supervision is a cause for concern Children are at increased risk of abuse by psychotic parents when incorporated into their delusional thinking (e.g. the baby is trying to punish me for my sins) Practitioners will obviously seek to obtain a psychiatric assessment in these cases, but practitioners must not be paralysed if that is not forthcoming. It is essential to continue with the assessment based on the behaviour of the parents and not the diagnosis.
tests, and it makes sense to consider that the higher the viral load, the higher the degree of infectivity. Treatments Antiviral treatments are available for the treatment of hepatitis C infection and are variably beneficial. Such treatments are not currently available during pregnancy or licensed in young infants. There is little experience in treating children with antivirus drugs. For this reason, routine testing of pregnant women is not recommended, but may be in the future. The transmission of antibody from mother to baby gives rise to a positive test in new-borns of mothers with hepatitis C antibodies but this does not necessarily indicate the presence of virus or active infection so much as the presence of maternal antibodies. The presence of active infection should be sought later in the first year of life. In those with active infection or ongoing illness, the specialist treatment of hepatitis C is increasingly effective. Treatment with Interferon, Ribavirin, or a combination of drugs is complicated and expensive and may require drugs by injection, but can be effective in excluding the virus from the body and possibly effecting long-term cure. This is likely to be increasingly available. is now a wide range of treatments, including many antiviral drugs, available for management of HIV infection. These drugs can be given during pregnancy so women already on treatment before they become pregnant can continue their medication throughout pregnancy. Treatment with antivirals will also reduce vertical transmission, therefore women who are not already receiving treatment should be offered treatment during pregnancy. Treatment given to the mother to prevent vertical transmission can be discontinued at delivery if she wishes, but the baby should then receive treatment for the first few weeks of life. Delivery by elective Caesarean section has also been shown to reduce vertical transmission. 6.9 Appendix 9 Impact of Mental Health Although most parents with psychiatric problems are able to care for children appropriately research has indicated that child-maltreating parents are often shown to have mental health problems. Non-compliance with medication without medical supervision is a cause for concern Children are at increased risk of abuse by psychotic parents when incorporated into their delusional thinking (e.g. the baby is trying to punish me for my sins) Practitioners will obviously seek to obtain a psychiatric assessment in these cases, but practitioners must not be paralysed if that is not forthcoming. It is essential to continue with the assessment based on the behaviour of the parents and not the diagnosis.