Hepatitis C virus infection during pregnancy and the newborn period - Are they opportunities for treatment?

M. Arshad, S. S. El-Kamary, Ravi Jhaveri*

*Corresponding author for this work

Research output: Contribution to journalReview article

67 Citations (Scopus)

Abstract

The worldwide prevalence of hepatitis C virus (HCV) infection in pregnant women is estimated to be between 1 and 8% and in children between 0.05% and 5%. While parenteral transmission is still common in children living in developing countries, perinatal transmission is now the leading cause of HCV transmission in developed countries. The absence of an HCV vaccine or approved therapy during pregnancy means that prevention of vertical transmission is still not possible. However, a low vertical transmission rate of 3-5%, a high rate of spontaneous clearance (25-50%) and delayed morbidity have resulted in HCV being overlooked in pregnant women and their infants. Yet a study of the natural history in mothers and children demonstrates that the prognosis of HCV can vary greatly and should be taken seriously. Factors known to increase the risk of perinatal transmission include HIV coinfection and higher maternal viral loads, while elective C-section and withholding breastfeeding have not been demonstrated to reduce vertical transmission. Current guidelines for the diagnosis of persistent perinatal infection require a positive anti-HCV test in infants born to infected mothers after 12 months or two positive HCV RNA tests at least 6 months apart. Current HCV treatment options using pegylated interferon and ribavirin are both unsuitable for use in pregnancy and infancy. However, new agents currently in preclinical phases of development, along with the recently identified association between single-nucleotide polymorphisms within the IL28 gene and treatment response, may serve to create a therapeutic window for these patients.

Original languageEnglish (US)
Pages (from-to)229-236
Number of pages8
JournalJournal of Viral Hepatitis
Volume18
Issue number4
DOIs
StatePublished - Apr 1 2011

Fingerprint

Virus Diseases
Hepacivirus
Newborn Infant
Pregnancy
Mothers
Therapeutics
Pregnant Women
Ribavirin
Breast Feeding
Natural History
Viral Load
Coinfection
Developed Countries
Interferons
Developing Countries
Single Nucleotide Polymorphism
Vaccines
HIV
Guidelines
RNA

Keywords

  • Hepatitis C virus
  • Infants
  • Pregnancy
  • Treatment
  • Vertical transmission

ASJC Scopus subject areas

  • Hepatology
  • Infectious Diseases
  • Virology

Cite this

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title = "Hepatitis C virus infection during pregnancy and the newborn period - Are they opportunities for treatment?",
abstract = "The worldwide prevalence of hepatitis C virus (HCV) infection in pregnant women is estimated to be between 1 and 8{\%} and in children between 0.05{\%} and 5{\%}. While parenteral transmission is still common in children living in developing countries, perinatal transmission is now the leading cause of HCV transmission in developed countries. The absence of an HCV vaccine or approved therapy during pregnancy means that prevention of vertical transmission is still not possible. However, a low vertical transmission rate of 3-5{\%}, a high rate of spontaneous clearance (25-50{\%}) and delayed morbidity have resulted in HCV being overlooked in pregnant women and their infants. Yet a study of the natural history in mothers and children demonstrates that the prognosis of HCV can vary greatly and should be taken seriously. Factors known to increase the risk of perinatal transmission include HIV coinfection and higher maternal viral loads, while elective C-section and withholding breastfeeding have not been demonstrated to reduce vertical transmission. Current guidelines for the diagnosis of persistent perinatal infection require a positive anti-HCV test in infants born to infected mothers after 12 months or two positive HCV RNA tests at least 6 months apart. Current HCV treatment options using pegylated interferon and ribavirin are both unsuitable for use in pregnancy and infancy. However, new agents currently in preclinical phases of development, along with the recently identified association between single-nucleotide polymorphisms within the IL28 gene and treatment response, may serve to create a therapeutic window for these patients.",
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Hepatitis C virus infection during pregnancy and the newborn period - Are they opportunities for treatment? / Arshad, M.; El-Kamary, S. S.; Jhaveri, Ravi.

In: Journal of Viral Hepatitis, Vol. 18, No. 4, 01.04.2011, p. 229-236.

Research output: Contribution to journalReview article

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AU - El-Kamary, S. S.

AU - Jhaveri, Ravi

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AB - The worldwide prevalence of hepatitis C virus (HCV) infection in pregnant women is estimated to be between 1 and 8% and in children between 0.05% and 5%. While parenteral transmission is still common in children living in developing countries, perinatal transmission is now the leading cause of HCV transmission in developed countries. The absence of an HCV vaccine or approved therapy during pregnancy means that prevention of vertical transmission is still not possible. However, a low vertical transmission rate of 3-5%, a high rate of spontaneous clearance (25-50%) and delayed morbidity have resulted in HCV being overlooked in pregnant women and their infants. Yet a study of the natural history in mothers and children demonstrates that the prognosis of HCV can vary greatly and should be taken seriously. Factors known to increase the risk of perinatal transmission include HIV coinfection and higher maternal viral loads, while elective C-section and withholding breastfeeding have not been demonstrated to reduce vertical transmission. Current guidelines for the diagnosis of persistent perinatal infection require a positive anti-HCV test in infants born to infected mothers after 12 months or two positive HCV RNA tests at least 6 months apart. Current HCV treatment options using pegylated interferon and ribavirin are both unsuitable for use in pregnancy and infancy. However, new agents currently in preclinical phases of development, along with the recently identified association between single-nucleotide polymorphisms within the IL28 gene and treatment response, may serve to create a therapeutic window for these patients.

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