Preventing hepatitis C transmission from mothers to babies

Hepatitis C virus (HCV) transmission from mothers to babies could largely be prevented if Canada recommended universal screening for HCV in pregnancy, argues a commentary in CMAJ (Canadian Medical Association Journal).

"We encourage all care providers to consider the reproductive implications of HCV, to consider HCV screening in pregnancy and referral for treatment of HCV," write Drs. Chelsea Elwood, Department of Obstetrics and Gynaecology, University of British Columbia, and Laura Sauve, BC Children's Hospital, University of British Columbia, Vancouver, BC. "The time has come to move toward universal HCV screening in women who are pregnant, with initial prenatal investigations that are then repeated based on risk factors in the third trimester."

Almost half of women infected with HCV are unaware of their infection, and current treatment with direct-acting antiviral regimens is quite effective.

"With the care gaps in both maternal screening in pregnancy and postnatal infant screening, Canada likely has a large cohort of infants, children and young adults with progressive liver disease, who could have been cured of the HCV infection if it had been identified early or, quite simply, would not have been infected at all," write the authors.

The elimination of vertical transmission of HCV from mother to child is achievable with collaboration of public health and health care professionals.