Question

Mother to Child Transmission of Hepatitis C.

Hint:

Mother-to-child transmission of HCV is most common during delivery, but the risk can be minimized by managing maternal HCV viral load and treating coinfection with HIV.

Answer 1

Mother-to-child transmission of Hepatitis C (HCV) occurs when the virus is transmitted from an infected mother to her baby during childbirth. The key points related to mother-to-child transmission include:
1. Risk Factors for Transmission:
- Maternal HCV Viral Load: Higher maternal HCV viral load, especially during pregnancy, increases the risk of vertical transmission.
- Coinfection with HIV: Mothers who are coinfected with HIV have a higher risk of transmitting HCV to the infant.
- Mode of Delivery: Cesarean delivery does not significantly reduce the risk of transmission, as the primary risk is during the passage through the birth canal.
2. Incidence of Transmission:
- The estimated rate of mother-to-child transmission of HCV is approximately 5-10%.
- The risk is generally lower in mothers with low or undetectable HCV RNA levels.
3. Prevention Strategies:
- No routine screening for HCV in pregnant women: HCV screening is not universally recommended for all pregnant women, but it should be considered in high-risk groups (e.g., women with a history of injection drug use).
- Antiviral Treatment during Pregnancy: There is currently no approved antiviral therapy during pregnancy to reduce the risk of HCV transmission, but treating mothers with HIV can reduce the overall transmission risk.
4. Postpartum Care:
- Infant Testing: Infants born to HCV-positive mothers should be tested for HCV. Initial testing is done after 18 months of age due to the possibility of the presence of maternal antibodies in the newborn.