Hepatitis C in pregnancy

Hepatitis C is the most common cause of chronic liver disease and liver transplantation, with 25,000 cases reported in the United States per year. By blood product screening, transfusion-related viral transmission has been virtually eliminated, and maternal fetal transmission is now one of the most important modes of transmission. Hepatitis C virus (HCV) infection is blood borne but only 25% of the infected pregnant women indicate a history of blood products transfusion or intravenous drug use. HCV transmission is 2- to 4-fold higher in women coinfected with HIV. Although cesarean delivery has not been shown to decrease perinatal transmission, it may have benefits in women with viremia at the time of delivery. During pregnancy, treatment of HCV is contraindicated, even though perinatal transmission is associated with a higher incidence of chronic liver disease. This review gives an update on the disease agent, risk factors, modes of transmission, diagnosis, treatment modalities, and perinatal issues that require further evaluation.