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Guidelines for the investigation of babies born to hepatitis C positive mothers have been published. [8]In children born to hepatitis C virus antibody positive but hepatitis C virus RNA negative mothers, the alanine aminotransferase and hepatitis C virus antibodies should be investigated at 18-24 months of life.
Worldwide the prevalence of hepatitis C virus infection in pregnant women and children has been estimated to be 1–8% and 0.05–5% respectively. [155] The vertical transmission rate has been estimated to be 3–5% and there is a high rate of spontaneous clearance (25–50%) in the children.
The hepatitis C virus (HCV) [3] is a small (55–65 nm in size), enveloped, positive-sense single-stranded RNA virus of the family Flaviviridae. The hepatitis C virus is the cause of hepatitis C and some cancers such as liver cancer ( hepatocellular carcinoma , abbreviated HCC) and lymphomas in humans.
Unlike hepatitis B, most cases of hepatitis C lead to chronic infection. [32] Hepatitis C is the second most common cause of cirrhosis in the US (second to alcoholic hepatitis). [33] In the 1970s and 1980s, blood transfusions were a major factor in spreading hepatitis C virus. [32]
Acute hepatitis A virus or acute hepatitis E virus infection present the greatest risk to maternal and fetal health and increased risk of adverse pregnancy outcomes. Hepatitis B, C and D virus present a risk of mother to child transmission but are dependent on the severity of the underlying disease in the mother.
The GB virus C is a virus that is probably spread by blood and sexual contact. [18] It was initially identified as Hepatitis G virus. [19] There is very little evidence that this virus causes hepatitis, as it does not appear to replicate primarily in the liver. [20] It is now classified as GB virus C. [21]
Hepatitis B may also be classified as a vertically transmitted infection. The hepatitis B virus is large and does not cross the placenta. Hence, it cannot infect the fetus unless breaks in the maternal-fetal barrier have occurred, but such breaks can occur in bleeding during childbirth or amniocentesis. [13]
Pregnant women with hepatitis C who take ribavirin have shown some cases of birth defects and death in their fetus. [23] It is recommended that sofosbuvir/ribarivin combinations be avoided in pregnant females and their male sexual partners in order to reduce harmful fetal defects caused by ribavirin.
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