Hepatitis C virus (HCV) infection is detected in 1–2% of pregnant women. The majority of these women will be persistently infected and, potentially, a source of infection for their children.
In Western Europe, Australia and North America, most HCV-infected individuals have a history of percutaneous exposure to the virus, and the majority are (or have been) intravenous drug users. Past drug use is, therefore, the most common source of infection in women during pregnancy.
Most HCV-positive women who are pregnant are in early stages of infection, which is typically asymptomatic. Most will have underlying chronic hepatitis and a small proportion will have developed cirrhosis.
HCV transmission from mother to child occurs in approximately 1 in 20 births.
General signs and symptoms include:
- dark urine
- abdominal pain
- loss of appetite
80% of people infected with hepatitis C have no signs or symptoms
Diagnosis in the neonate
Diagnosis of HCV transmission is generally made by polymerase chain reaction (PCR) for HCV RNA sequences in plasma. Maternal antibodies to HCV can be detected in all samples from neonates collected around the time of birth. It subsequently declines in time in those who are HCV uninfected, with most children being negative by one year.
An algorithm describing the samples and tests required for accurate determination of infant HCV status has been prepared by the Public Health Laboratory Service (PHLS).