f. Hepatitis B (HBV, Also, please enter the HBsAg test See Chlamydia Hepatitis B serum hepatitis) date and result on the Hep B Immunization screen. HBV A positive test for the hepatitis B Treatment or Rx for any of the virus If there is no result available an above HBsAg test should be performed HBsAg and the infant should receive Hep B vaccine within 12 hours of birth. g. Hepatitis C (non A, non B Check box if lab results indicate See Hepatitis B Hep C hepatitis, HCV) the presence (past or present) of HCV the Hepatitis C virus or if the Treatment or diagnosis for any A positive test for the hepatitis C medicate records documents of the above virus diagnosis or treatment of acute or chronic Hepatitis C HCV RNA RIBA Anti-HCV Signal to cutoff ratio See bacterial vaginosis h. Herpes Simplex Virus Check box if current infection or HSV past history of infection Treatment, diagnosis for HSV A positive laboratory test for Herpes Simplex Virus (HSV). In Utero Infection Please note that TORCH is a term (TORCHS) used for the infection of the fetus and not the mother, and is already addressed in other options. This item will be removed in a future version of the worksheet. Please do not select this option.
f. Hepatitis B (HBV, serum hepatitis) A positive test for the hepatitis B virus Also, please enter the HBsAg test date and result on the Immunization screen. If there is no result available an HBsAg test should be performed and the infant should receive Hep B vaccine within 12 hours of birth. See Chlamydia Hepatitis B Hep B HBV Treatment or Rx for any of the above HBsAg g. Hepatitis C (non A, non B hepatitis, HCV) A positive test for the hepatitis C virus HCV RNA RIBA Anti-HCV Signal to cutoff ratio Check box if lab results indicate the presence (past or present) of the Hepatitis C virus or if the medicate records documents diagnosis or treatment of acute or chronic Hepatitis C See Hepatitis B Hep C HCV Treatment or diagnosis for any of the above h. Herpes Simplex Virus A positive laboratory test for Herpes Simplex Virus (HSV). Check box if current infection or past history of infection See bacterial vaginosis HSV Treatment, diagnosis for HSV In Utero Infection (TORCHS) Please note that TORCH is a term used for the infection of the fetus and not the mother, and is already addressed in other options. This item will be removed in a future version of the worksheet. Please do not select this option.
Guide_MPM_BC_Facility_Worksheet_Guidelines.10.14.docx