What is hepatitis C?

Hepatitis C is a disease caused by an RNA virus. Up to 70% of patients infected by the virus are asymptomatic. 

How can I get hepatitis C?

Hepatitis C is transmitted through contact with infected blood. IV drug use is the primary cause of infection through tainted blood. Current blood testing procedures have all but eliminated transmission via blood transfusion. About 5% of cases are transmitted during sexual contact. 

Symptoms and signs

The majority of hepatitis C infections are asymptomatic. Yellowing of the skin is typically one of the first symptoms. This symptom appears in about 10% of cases and resolves without additional symptoms. Most patients that develop chronic hepatitis C lack symptoms.

Symptoms that may appear after infection include:

• Pain in the right upper abdomen
• Swelling of the abdomen
• Pale stool
• Fever
• Fatigue
• Itching
• Diminished appetite
• Upset stomach
• Vomiting
• Dark-colored urine
• Cirrhosis of the liver
• Jaundice

Can I test for hepatitis C during pregnancy?

According to the CDC April, 2020 recommendations hepatitis C screening should be done on all for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection (HCV RNA-positivity) is <0.1%.

If you are pregnant you can be tested for hepatitis C, and if you follow the CDC recommendations, the test should be part of normal prenatal testing. If you are at an increased risk of infection, due to intravenous drug use or positive HIV test, testing can be completed. EIA assay and hepatitis C RNA assay tests will be ordered to diagnose the condition and report viral load. Albumin, liver function, and prothrombin time tests may also be ordered to check for damage to the liver or to assess liver function during pregnancy.

What are the potential complications with hepatitis C in pregnancy?

Hepatitis C passes from birth mother to infant about 5% of the time. This equates to infant-infection during 1 in 20 births. There are no medical measures available to prevent transmission during childbirth. There are no clinical studies reporting adverse outcomes on pregnancy, but there have been reports of premature delivery in women with hepatitis C. No increased risk of stillbirth, fetal malformation, or fetal malnutrition has been reported.

Treatment for hepatitis C during pregnancy

The aim of hepatitis C treatment is to reduce the presence of the virus in the blood. Antiviral medications are often the first treatment of choice, but not all medications used to treat the virus are safe for use during pregnancy. Ribavirin, one antiviral medication used to treat hepatitis C, is not safe during pregnancy or for six months following pregnancy. When treatment is approved, injections of pegylated interferon alfa typically last for up to 48 weeks. Injections are supplemented with ribavirin.

Can I breastfeed with hepatitis C?

Breastfeeding with hepatitis C does not appear to increase the risk of transmission to an uninfected infant, but the National Institutes of Health suggests talking with your physician about feeding options and potential risk factors before breastfeeding.