Hepatitis C in pregnancy

Hepatitis C is a liver infection caused by a virus that is transmitted through contact with the blood of an infected person. Hepatitis C can also spread from using intravenous drugs (drugs injected with a needle) or from tattoos done with needles and paints that have not been properly sterilized (cleaned). Very rarely, hepatitis C can come from having unprotected sex with an infected person. About 1 in 20 children born to a mother with chronic hepatitis C become will become infected during pregnancy or delivery. Among street-involved youth, injection drug use is the main risk factor. Before 1991, children sometimes got hepatitis C from blood transfusions. This almost never happens now because blood is screened. Most people have no symptoms. Some people will have nausea and jaundice (yellow skin and eyes) when they are first infected. Sometimes the body can clear the virus on its own, but usually the virus stays in the liver. People who have the virus in their liver for more than 6 months are known as hepatitis C carriers. Most carriers live for many years without major health problems, but some develop severe liver damage (cirrhosis) or cancer of the liver. These complications usually happen many years after a person first gets infected with hepatitis C. Doctors typically only do a blood test for hepatitis C for patients who are at risk. If you have ever used intravenous drugs, even just once, you should ask to be tested. Testing for hepatitis C may eventually become a routine test in all pregnancies. There is no need to do a Caesarian section just because you have hepatitis C. If you have hepatitis C, you should be referred to specialists who deal with this infection. Treatments exist, but the need for and timing of treatment can be assessed after your baby is born. Your baby will need to be tested for hepatitis C only if you test positive. Sometimes testing is done as early as 2 months of age, but it is not totally accurate at this age. It will need to be done again at 18 months of age. If you have hepatitis C, there is about a 1 in 20 chance that you will pass it to your baby. The risk is higher if you also have HIV and are not being treated. Unfortunately, there is no way to fully eliminate the risk of spread of hepatitis C to your baby. Studies have shown that the chance of passing hepatitis C to your baby from breastfeeding is very low. You can breastfeed if you have hepatitis C, unless you also have HIV. However, if you have hepatitis C and experience a flare-up of the illness with jaundice after your baby is born, you should not breastfeed. If your nipples are cracked or bleeding, you should also stop breastfeeding and pump and discard your milk until your nipples have healed. Approximately 1 in 5 children with hepatitis C clear the virus on their own. The others become carriers. Even though the virus stays in the liver of children who are carriers, most stay healthy. Children who are hepatitis C carriers will see their doctors regularly and have blood tests. Treatment is usually not required for many years. However, as the evidence for use of new medications in children becomes available, it is likely that many children with chronic infection will be treated. Testing for HIV during pregnancy Infectious Diseases and Immunization Committee