Reducing the Risk of Transmission During and After Pregnancy

A woman living with Hep C who wishes to become pregnant may have particular anxieties about the health of her baby. The chance of the virus being transmitted to the baby is 5-10%, and higher in persons who have HIV as well. If a mother also has AIDS, the chances can increase up to 36 in 100. The risk may be even greater in mothers who are infected with both Hep B and Hep C.

Transmission to the baby can happen before or during birth. In parts of the world with lower standards of general health, transmission from a woman with Hep C to her baby is more likely. Most doctors and midwives will be helpful and supportive to a woman with Hep C who wants a child. Pregnanacy with Hep C is not officially discouraged.

 

Viral Load and Mother-to-Baby Transmission

Viral load is the amount of Hep C in the blood. If a woman with Hep C has low viral load (less than 1 million copies/mL), it is less likely that the virus will be passed to her baby than if she has high viral load. However, even if viral load is very low, there is still a chance that Hep C will be transmitted.

Given the low risk of transmission from mother to infant there is not enough information at present regarding the use of Caesarean sections to reduce the risk of transmission. However, it is possible that if a woman has an acute case of Hep C, there is more of a risk of her baby being infected.

 

Breast Feeding

It is not yet known whether the breast milk of a woman with Hep C contains enough virus to infect a baby during breast feeding. Generally, women with Hep C are not advised to avoid breast feeding. No studies have documented transmission of Hep C infection to infants by breast-feeding.

 

Children with Hep C

In children, viral infection is usually silent, although children as young as 8 years old can become quite ill from HCV.

Children are less likely than adults to have symptoms of infection with Hepatitis C, and thus may be able to transmit the virus unknowingly.

Having hepatitis C does not seem to affect a child? growth.

All children, with or without hepatitis C, should be taught proper hygiene.

 

Children and Advanced Liver Disease

Chronic hepatitis C can cause cirrhosis or cancer. It is thought that hepatitis C causes cirrhosis in 20-30% of chronically infected people over a span of 20-30 years. Liver cancer rarely occurs in children.

 

Treatment in Children

Few studies exist examining interferon (IFN) use in children with chronic HCV. A recent study suggests that IFN therapy may benefit children with chronic HCV, and indeed, children may respond better than adults, possibly because they have been infected for less time and have a milder disease. Interferon is used in children only in clinical trials in Canada at this time. Another drug, called ribavirin, is being used in combination with IFN in adults and may be recommended for children in the future.

There are still many questions about Hepatitis C in children. More studies are necessary to learn more about how the disease progresses and about different treatments.

 

Talking to Health Care Workers

Doctors and midwives can be helpful and supportive to a woman with Hep C who wants a child. It can be very hard for a woman with Hep C to tell her health care workers she is pregnant or wants to be, if she suspects they will try to change her mind. Staff with experience of working with women who have Hep C are likely to be the best informed and most supportive.

 

©HepCBC, 2001
 

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