If a person who is pregnant becomes infected with hepatitis C, there is a risk that the fetus will also become infected. This is because the blood supply is shared. During this time, it is also unlikely that doctors will begin the hepatitis C treatment protocols because the medications can hurt a fetus or impact the safety of the pregnancy. However, during this time, the mother may be instructed to alter her diet and increase her level of exercise in order to keep her body as healthy as possible. In this situation, the fetus may thrive because of the additional nutrients and healthier lifestyle. It is very uncommon for a fetus to be tested for hepatitis C. This is because doctors believe that testing fetuses for anything other than absolutely necessary fetal development diagnoses can cause more harm than good. Tests to the fetus that check for blood disorders or viruses within the fetal blood are considered invasive and they require needles or other instruments penetrating the mother’s abdominal wall, the uterus, and the fetus. During this process, there is risk of complication, including the inherent risks to the mother of performing any procedure. The risks to the fetus can be much greater. They can include problems for the fetal sac related to bleeding around it or the sac not properly healing and sealing, which could cause a leak of amniotic fluid within the mother’s abdominal cavity, as well as leading to not enough fluid for the fetus. This can create fetal distress which may even result in preterm labor. If this occurs, there may be long-term or permanent risks to the fetus or even result in death if the baby is born too prematurely to survive. With these risks in mind, doctors understand why some mothers with hepatitis C may wish to know whether their baby has been infected while in the womb, however, doctors will not provide this test unless there is another reason to perform surgery or invasive procedures on the fetus. Even in these cases, doctors typically do not test the fetus for the same reasons that babies are not tested at birth; their body has not yet had time to potentially fight off the hepatitis C virus on its own. Since any positive diagnosis at this stage would result in the treatment of simply waiting and seeing whether the tiny body can rid itself of the virus, and since risks are so great, fetuses are not tested, even if the mother has tested positive for hepatitis C.
From Birth to Childhood
When the baby is born, the mother’s ability to begin the hepatitis C treatment protocol will be impacted by her decision regarding breast feeding. This is because many medications can be transmitted to the baby via breast milk. In some cases, newer medications may not be studied long enough to know whether the drugs impact the mother’s milk, which may mean that there will not be a warning label outlining the impacts of exposing a baby to the drug. However, the warning information will instead explain that the effects are unknown and, when this is the case, doctors do not ever recommend exposing a baby to the drug simply because the side effects may be long-lasting and dangerous for the baby. Depending on the mother’s body, doctors may agree to wait to begin treatment because they see more value in breastfeeding the newborn, or they may insist on beginning treatment right away, due to the impact the virus is having on the mother’s body. In these cases, the doctor will discuss alternative formula based options with the mother.
In up to 25% of cases, when a person is infected with the hepatitis C virus, their body fights the infection and beats it. The number may be higher or lower for infants, it has not been studied well enough for this specific age range to know. Based on this, and because medication is not regulated for new babies, most doctors choose not to test the baby for hepatitis C right away. Instead, they often monitor the baby and keep watch on the baby’s organs. This allows the baby the chance to fight off the infection naturally and it keeps the baby from being exposed to the side effects of hepatitis C treatment medication unless it is absolutely necessary. Some parents may feel worried or nervous that their child may have hepatitis C without them knowing, however even a positive test result would yield the same treatment method, so there is typically no reason for doctors to perform a blood test, since it would be exposing the baby to a momentarily painful needle stick without offering any new treatment options if the outcome was positive.1-4
Check out Part 2 of Does My Age Impact My Likelihood of Getting HCV.
Chen, S. (2006). The Natural History of Hepatitis C Virus (HCV) Infection. International Journal Of Medical Sciences, 47. http://dx.doi.org/10.7150/ijms.3.47
HCV FAQs for Health Professionals | Division of Viral Hepatitis | CDC. (2016). Cdc.gov. Retrieved 24 September 2016, from http://www.cdc.gov/hepatitis/hcv/hcvfaq.htm
High, K., Marcus, E., & Tur-Kaspa, R. (2005). Chronic Hepatitis C Virus Infection in Older Adults. Clinical Infectious Diseases, 41(11), 1606-1612. http://dx.doi.org/10.1086/497597
Li, W., Lee, Y., Chen, I., Wang, S., Hsiao, C., & Loke, S. (2013). Age and gender differences in the relationship between hepatitis C infection and all stages of Chronic kidney disease. Journal Of Viral Hepatitis, 21(10), 706-715. http://dx.doi.org/10.1111/jvh.12199