HCV Challenges

The increased reported incidence of HCV infection among persons aged ≤39 years indicates there may be an increase in the number of pregnant women with HCV infection and more infants who might be exposed to HCV at birth.1 CDC’s recommendations to screen pregnant women for HCV during each pregnancy may aid practitioners in identifying HCV-infected mothers, which can lead to treatment for the mother during the postpartum period, and identify infants who should receive testing at a pediatric visit. However, there are currently no treatments approved for use in pregnancy to prevent transmission of HCV to infants. The risk of an HCV-infected mother transmitting infection to their infant is approximately 4% to 7% per pregnancy, but the risk is significantly higher if the mother has a high viral load or is coinfected with HIV.2

Screening

CDC recommends screening pregnant women during each pregnancy, and then testing infants born to mothers with HCV infection. Follow-up of this group to determine if the infant has hepatitis C can be challenging. Testing infants consists of HCV RNA testing at or after age 1-2 months or anti-HCV testing at or after age 18 months.3,4

Access To and Availability of Treatment

No recommended curative treatments are available for pregnant women or young children (aged <3 years), but curative treatments are available to older children (aged ≥3 years) and women who are not pregnant.

Knowledge

The natural history of HCV infection passed from mother to infant is not well- understood and needs additional study.

References
  1. Centers for Disease Control and Prevention. Surveillance for Viral Hepatitis – United States, 2015. Accessed September 19, 2017.
  2. Roberts EA, Yeung L. Maternal-infant transmission of hepatitis C virus infection. Hepatology. 2002;36(5 Suppl 1):S106-13.
  3. American Association for the Study of Liver Diseases (AASLD); Infectious Diseases Society of America (IDSA). HCV guidance: recommendations for testing, managing, and treating hepatitis C. Alexandria and Arlington, VA: AASLD and IDSA; 2019.
  4. American Academy of Pediatrics. Consideration for Testing for infectious Agents. Red Book: 2018-2021 Report of the Committee on Infectious Diseases. Elk Grove Village, IL
Page last reviewed: May 22, 2019