Substance Misuse in Pregnancy - NHS Lothian

Hepatitis C (HCV)
Hepatitis C is a virus, which affects the liver and can be passed from
mother to baby, either during pregnancy or childbirth, but not through
breast feeding. The transmission rate is thought to be low (below 5%).
People who are chronically infected with hepatitis C can remain well for
many years and may not know they are infected. Babies who are infected
are at risk of developing serious liver disease later in life. Unfortunately,
there is no vaccine currently available for hepatitis C. Combination
therapy drug treatment for hepatitis C (interferon alpha & ribavirin) is
contraindicated during pregnancy and breastfeeding (because of
foetotoxic and teratogenic effects) and in young babies and children. As
yet, there are no proven interventions to prevent or reduce the risk of
vertical transmission (except in the case of co-infection, see below).
Breast feeding is encouraged as there is no evidence that HCV can be
transmitted by this route. Universal screening of all pregnant women is
therefore not recommended.
Identifying hepatitis C infection in pregnancy is still useful however, for a
number of reasons:
� the woman’s health can be monitored
� she can be given healthy lifestyle advice
� she can be given advice to prevent further risk of exposure
� she can be immunised against hepatitis B and hepatitis A
� she can be given information on infection control in the home and
elsewhere
� she can be referred for specialist treatment once the baby is
delivered.
Antenatal testing is also useful because infected babies can be identified,
they can be immunised against hepatitis B and their paediatric care can be
managed appropriately. Dr Jacqueline Mok, Paediatrician at RHSC, is part
of the European paediatric Hepatitis C Network and will see all infants
born to mothers with HCV. Infants are monitored for signs and symptoms
of hepatitis C during the first year of life. Blood tests are also carried
out using PCR techniques.
Substance Misuse in Pregnancy: Appendix 1 6