Caesarean section versus vaginal delivery for preventing mother to infant hepatitis C virus transmission

Global epidemiology of hepatitis C virus infection: New estimates of age-specific antibody to HCV seroprevalence

“…Contrary to the literature describing Australia as having very low prevalence and type 1 transmission, our findings may be due to fewer datapoints beyond age 40, resulting in borrowing of strength and more influence from younger ages with higher prevalence for the Australasian region. Mother‐to‐infant transmission is the commonest route of HCV infection in children, with a vertical transmission rate of 5% 30. In West sub‐Saharan Africa, the relatively high prevalence in young children may reflect the overlapping human immunodeficiency virus (HIV) epidemic and HIV‐HCV coinfection in sub‐Saharan Africa, which is known to increase the risk of vertical transmission of HCV and requires further investigation 31.…”

Discordant outcome of perinatal transmission of hepatitis C in twin pregnancies

“…A recent review which sought evidence for a policy of prelabour elective caesarean section in the reduction of risk for mother to baby transmission of hepatitis C failed to locate any randomised controlled trials (McIntyre et al, 2006). However, this review did not include studies on twin pregnancies.…”

“…Recent studies (European Paediatric HCV Network, 2005;Mast et al, 2005) have also observed that HCV infection rates are doubled in female to male infants and that virus transmission is increased with earlier membrane rupture. Breast-feeding does not correlate with transmission, but the effect of elective caesarean section is still unproven (European Paediatric HCV Network, 2001Gibb et al, 2000;Mast et al, 2005;McIntyre et al, 2006). Intra-uterine and intrapartum hepatitis C infections 1386-6532/$ -see front matter © 2006 Elsevier B.V. All rights reserved.…”

Neonatal Cholestasis

“…121 If vertical transmission occurs, the infant will usually be positive for HCV PCR by 12 months of life; whereas passively transmitted antiHCV antibodies are present for at least 18 months. 124 As far as breastfeeding, HCV RNA is present is breast milk in a high percentage of HCVpositive mothers; despite this, most studies have not demonstrated a risk for postpartum HCV trans mission associated with breast milk. 118,122 Moreover, the absence of viremia in the mother predicts no risk for HCV vertical transmission.…”