Vertical transmission of HCV

Case: 24 years old female with known history of Hepatitis C (HCV) and HIV is in ICU. She is 37 weeks pregnant. Ob-Gyn service asked your opinion about vertical transmission of HCV if patient requires to go to OR?

Answer: Some of the well-known factors in the vertical transmission of HCV in a pregnant patients are:

• HCV viremia
• HIV coinfection
• Maternal intravenous drug use
• Peripheral blood mononuclear cell infection 
• Invasive prenatal testing
• Prolonged rupture of membranes, and
• Invasive obstetric procedures

Any increase in the risk of exposure of the fetus to maternal blood may increase the risk of transmission.

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References:

1. Ades AE, Gordon F, Scott K, Collins IJ, Claire T, Pembrey L, Chappell E, Mariné-Barjoan E, Butler K, Indolfi G, Gibb DM, Judd A. Overall Vertical Transmission of Hepatitis C Virus, Transmission Net of Clearance, and Timing of Transmission. Clin Infect Dis. 2023 Mar 4;76(5):905-912. doi: 10.1093/cid/ciac270. PMID: 35403676; PMCID: PMC9989130.

2. Fauteux-Daniel S, Larouche A, Calderon V, Boulais J, Béland C, Ransy DG, Boucher M, Lamarre V, Lapointe N, Boucoiran I, Le Campion A, Soudeyns H. Vertical Transmission of Hepatitis C Virus: Variable Transmission Bottleneck and Evidence of Midgestation In Utero Infection. J Virol. 2017 Nov 14;91(23):e01372-17. doi: 10.1128/JVI.01372-17. PMID: 28931691; PMCID: PMC5686730.