What is hepatitis C virus?

Hepatitis C virus (HCV) is a virus that can injure the liver and cause long-term damage. The liver is an organ that helps your body get rid of toxins.

The main way HCV is spread is from person to person through infected blood. You can be exposed to HCV-infected blood by sharing needles used to inject illegal drugs or if you have a job that brings you into contact with blood (e.g., health care worker). HCV also can be passed from mother to child during pregnancy. Sexual intercourse is another way HCV is spread, but it is not as likely.

What happens if I become infected with HCV?

The first 6 months of HCV infection is called acute infection. Acute HCV infection may cause abdominal pain, nausea, weight loss, fatigue, and jaundice (yellowing of the skin and eyes caused by liver cell damage). HCV infection also can occur without any symptoms. In about 15% of people who don’t receive treatment, HCV goes away by itself within 6 months. In the rest of those infected (85%), the virus does not go away. This is called chronic infection. Chronic infection can lead to cirrhosis, a serious and permanent liver disease; liver failure; and liver cancer.

Is there a test for HCV?

Yes. A blood test can show whether you have been infected with HCV. It looks for antibodies made by your immune system against the virus. This is called an HCV antibody test. If HCV antibodies are found in your blood, you will have another test that looks for the virus. This is called an HCV RNA test (RNA is the genetic material of the virus). All pregnant people should be tested for HCV.

How is HCV infection treated?

New antiviral medications for chronic HCV have been developed in recent years. Many people who receive this treatment are cured. This means that no virus is found in the blood 3 months after completing treatment. Currently, however, treatment for HCV is not recommended during pregnancy (see below).

How can being infected with HCV affect my pregnancy?

You may be more likely to develop problems that can affect your health and that of your fetus, including diabetes during pregnancy and a liver disease called intrahepatic cholestasis of pregnancy (ICP). Babies born to people with HCV may be smaller than average and are more likely to be born early. But it is not clear whether these problems are caused by HCV or by other factors.

Is it possible to pass the virus to my baby during pregnancy?

Yes, HCV can be passed to your fetus during pregnancy. This is called vertical transmission. The risk of vertical transmission is about 5%. The risk of vertical transmission is higher (about 10%) if you have both HCV and human immunodeficiency virus (HIV). Vertical transmission happens most often in people who have HCV RNA in their blood, although it’s a concern for all pregnant women with HCV infection.

Can HCV infection be treated during pregnancy?

There is not much information about how medications used to treat HCV can affect a developing fetus. Research is currently being done to study the safety of HCV treatment during pregnancy. Until more safety information is available, treatment of HCV with antiviral medication is not recommended during pregnancy.

How is HCV infection managed during pregnancy?

If you first become infected with HCV during your pregnancy, you should see a doctor specializing in infections or liver diseases. A specialist can evaluate your health and set up a long-term care plan, which may may include taking antiviral medication after your pregnancy.

You should not drink alcohol if you have HCV infection, whether you are pregnant or not. Alcohol can increase the risk of liver damage.

It is possible, although not very likely, that having tests such as amniocentesis or chorionic villous sampling (CVS) could increase the risk of passing HCV to the fetus. However, the chances of this happening are very small.

Can I plan to have my baby vaginally if I have HCV?

You can plan to deliver your baby vaginally if you are infected with HCV. Cesarean delivery has not been shown to prevent or reduce transmission of HCV to the baby.

Will my baby be tested for HCV?

Babies born to women with HCV infection should be tested for HCV. Testing the baby for HCV can be done in one of two ways:

1. An HCV antibody test after your baby turns 18 months old.

2. Two separate HCV RNA tests after your baby turns 1 month old.

Can I breastfeed my baby if I have HCV?

Yes. There is little to no risk of passing HCV to your baby through breastfeeding unless your nipples are cracked or bleeding. If you have cracked or bleeding nipples, milk should be expressed and then thrown away and not fed to the baby. You can return to breastfeeding after your nipples have healed.

Updated on September 25, 2021

Quick Facts for Pregnant Women With HCV Infection

• All pregnant people should be tested for HCV infection.

• There is a small chance of passing HCV to the fetus if you are pregnant and are infected with HCV..

• Treatment can cure HCV infection, but it should be given either before or after pregnancy.

• If you become infected with HCV during pregnancy, you should see an infection or liver disease specialist to learn about your treatment options.

• You should not drink alcohol at any time if you are infected with HCV.

• You can breastfeed if you have HCV infection.

• Your baby should be tested for HCV infection.

Glossary

Amniocentesis: A procedure in which a sample of amniotic fluid is removed from the uterus during pregnancy and tested to look for genetic problems in the fetus.

Antibodies: Proteins made by the immune system in response to a foreign substance, such as a virus.

Antiviral Medications: Drugs that treat viral infections.

Chorionic Villus Sampling (CVS): A procedure in which a small sample of the villi, a part of the placenta, is removed and tested to look for genetic problems in the fetus.

Cirrhosis: A disease that affects the liver and its ability to rid the body of toxins and to perform other functions.

Human Immunodeficiency Virus (HIV): A virus that attacks cells of the immune system, causing diseases that the body would normally fight off, including certain infections and types of cancer.

Immune System: The cells and organs that protect the body against foreign substances, such as bacteria and viruses.

Intrahepatic cholestasis of pregnancy (ICP): A condition that affects pregnant women in which the normal flow of bile from the liver to the small intestine is slowed or stopped.

Maternal-Fetal Medicine Subspecialist: An obstetrician with specialized training in prenatal care for women with high-risk pregnancies.

Vertical transmission: Transmission of an infection from mother to fetus or baby during pregnancy or childbirth.