a pregnant mom holds up a tiny onesie in front of a yellow background

Hepatitis C in Newborns

The hepatitis C virus (HCV) is usually spread when an adult comes into contact with blood from an infected person.

However, babies are at risk of becoming infected with the virus if they are born to a mother who has HCV. In most cases, the mother passes the virus to her unborn baby during pregnancy.

Babies may also be infected at the time of delivery. Research shows this risk is the same for babies born through vaginal or cesarean (C-section) delivery.1

About 6 out of every 100 babies born to mothers with HCV will become infected with the virus. This risk is higher if the mother has a high viral load or both HCV and HIV.2

What are the symptoms of hepatitis C in newborns?

Infants with HCV may not show any symptoms. But in some babies, symptoms may start to appear when they are 6 to 9 weeks old. Symptoms may include:3

  • Fever
  • Diarrhea
  • Dark-colored urine
  • Poor appetite
  • Drowsiness
  • Jaundice (the skin and whites of the eyes look yellow)
  • Enlarged liver or spleen

Some infants with HCV may have trouble gaining weight and grow more slowly than other children.4

Are newborns treated for hepatitis C?

As of early 2022, there are no approved HCV treatments for children under age 3. About 40 percent of children infected with HCV at birth will clear the infection on their own without treatment.

This usually happens by the time a child is 2 years old.3-5,7

Doctors do not treat HCV in babies, but they recommend that all babies born to a mother with HCV be tested for the virus.3-5,7

How are newborns tested for hepatitis C?

Pregnant women should be screened for hepatitis C during pregnancy. Babies born to women who test positive for HCV are typically tested when they are 1 to 2 months old. This is done through blood tests. A positive result means the baby has an active HCV infection.3-5,7

Doctors recommend that babies born to mothers with HCV be tested again when they are about 18 months old. This is also done through blood tests.

However, these tests look for antibodies to HCV. These antibodies are present in anyone who has cleared the virus, has been cured or is still infected with HCV.3-5,7

Diagnosing and treating children with HCV

If a child still tests positive for HCV after the age of 2, they have what is called "chronic HCV." Many children with chronic HCV have no visible symptoms or side effects.3-5

As of 2022, interferon and ribavirin are the only approved HCV treatments for children under 12. Studies show that these direct-acting antiviral drugs (DAAs) are highly effective in curing HCV in kids and teens.3-6

If left untreated, chronic HCV can cause liver problems, including chronic liver disease and even liver failure. Children whose infection is not treated may also develop cirrhosis or have extensive scarring of the liver. Cirrhosis and liver failure require a liver transplant.3-5

HCV can also place a child at risk for other liver diseases, including liver cancer. Children with chronic HCV should regularly see a pediatric hepatologist.

This is a doctor who treats liver conditions in kids. They use several tests to monitor children with HCV, including those to check:3-5

  • Liver function
  • Viral load
  • HCV genotype
  • Liver cancer status

Things to consider for mothers with HCV

Right now, there is no approved treatment that prevents mothers with HCV from transmitting the virus to their unborn babies.4

Research shows that it is safe for mothers with HCV to breastfeed their babies. However, if the mother has nipples that are cracked or bleeding, they should pump and dispose of their breastmilk.

They should continue doing this until their nipples are no longer bleeding or cracked. This is because HCV can be transferred through blood.2

If you have HCV and are pregnant, talk with your doctor about steps you should take when your baby is born. If you have HCV and have recently given birth, see your baby's pediatrician for follow-up visits and any recommended testing.

This can help you keep your baby as healthy as possible.

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