HCV in children and pregnancy

Infections of the hepatitis C virus (HCV) in children and pregnant women are less understood than those in other adults. Worldwide, the prevalence of HCV infection in pregnant women and children has been estimated to 1-8% and 0.05-5% respectively.[1] The vertical transmission rate has been estimated to be 3-5% and there is a high rate of spontaneous clearance (25-50%) in the children. Higher rates have been reported for both vertical transmission (18%, 6-36% and 41%).[2][3] and prevalence in children (15%).[4]

In developed countries, transmission around the time of birth is now the leading cause of HCV infection. In the absence of virus in the mother's blood, transmission seems to be rare.[3] Factors associated with an increased rate of infection include membrane rupture of longer than 6 hours before delivery and procedures exposing the infant to maternal blood.[5] Cesarean sections are not recommended. Breastfeeding is considered safe if the nipples are not damaged. Infection around the time of birth in one child does not increase the risk in a subsequent pregnancy. All genotypes appear to have the same risk of transmission.

HCV infection is frequently found in children who have previously been presumed to have non-A, non-B hepatitis and cryptogenic liver disease.[6] The presentation in childhood may be asymptomatic or with elevated liver function tests.[7] While infection is commonly asymptomatic both cirrhosis with liver failure and hepatocellular carcinoma may occur in childhood.

  1. ^ Arshad M, El-Kamary SS, Jhaveri R (2011). "Hepatitis C virus infection during pregnancy and the newborn period--are they opportunities for treatment?". Journal of Viral Hepatitis. 18 (4): 229–236. doi:10.1111/j.1365-2893.2010.01413.x. PMID 21392169. S2CID 35515919.
  2. ^ Hunt CM, Carson KL, Sharara AI (1997). "Hepatitis C in pregnancy". Obstet Gynecol. 89 (5 Pt 2): 883–890. doi:10.1016/S0029-7844(97)81434-2. PMID 9166361. S2CID 23182340.
  3. ^ a b Thomas SL, Newell ML, Peckham CS, Ades AE, Hall AJ (1998). "A review of hepatitis C virus (HCV) vertical transmission: risks of transmission to infants born to mothers with and without HCV viraemia or human immunodeficiency virus infection". Int J Epidemiol. 27 (1): 108–117. doi:10.1093/ije/27.1.108. PMID 9563703.
  4. ^ Fischler B (2007). "Hepatitis C virus infection". Semin Fetal Neonatal Med. 12 (3): 168–173. doi:10.1016/j.siny.2007.01.008. PMID 17320495.
  5. ^ Indolfi G, Resti M (2009). "Perinatal transmission of hepatitis C virus infection". J Med Virol. 81 (5): 836–843. doi:10.1002/jmv.21437. PMID 19319981. S2CID 21207996.
  6. ^ González-Peralta RP (1997). "Hepatitis C virus infection in pediatric patients". Clin Liver Dis. 1 (3): 691–705. doi:10.1016/s1089-3261(05)70329-9. PMID 15560066.
  7. ^ Suskind DL, Rosenthal P (2004). "Chronic viral hepatitis". Adolesc Med Clin. 15 (1): 145–58, x–xi. doi:10.1016/j.admecli.2003.11.001. PMID 15272262.