Infections of the hepatitis C virus (HCV) in children and pregnant women are less understood than those in other adults. Worldwide, the prevalence of HCV infection in pregnant women and children has been estimated to 1-8% and 0.05-5% respectively. [1] The vertical transmission rate has been estimated to be 3-5% and there is a high rate of spontaneous clearance (25-50%) in the children. Higher rates have been reported for both vertical transmission (18%, 6-36% and 41%). [2] [3] and prevalence in children (15%). [4]
In developed countries, transmission around the time of birth is now the leading cause of HCV infection. In the absence of virus in the mother's blood, transmission seems to be rare. [3] Factors associated with an increased rate of infection include membrane rupture of longer than 6 hours before delivery and procedures exposing the infant to maternal blood. [5] Cesarean sections are not recommended. Breastfeeding is considered safe if the nipples are not damaged. Infection around the time of birth in one child does not increase the risk in a subsequent pregnancy. All genotypes appear to have the same risk of transmission.
HCV infection is frequently found in children who have previously been presumed to have non-A, non-B hepatitis and cryptogenic liver disease. [6] The presentation in childhood may be asymptomatic or with elevated liver function tests. [7] While infection is commonly asymptomatic both cirrhosis with liver failure and hepatocellular carcinoma may occur in childhood.
Guidelines for the investigation of babies born to hepatitis C positive mothers have been published. [8]
Treatment of children has been with interferon and ribavirin. [9] The response to treatment is similar to that in adults. [10] It shows a similar dependence on the genotype. Recurrence after transplant is universal and the outcomes after transplant are usually poor. [11]
In children treatment should be initiated within 12 weeks of the detection of the viral RNA if viral clearance has not occurred within this time. [12] Given the difficulties with establishing a diagnosis of hepatitis C infection in infancy, this recommendation does not apply to infants.[ citation needed]
Both pegylated interferon and ribavirin are unsuitable for use in pregnancy and infancy: newer methods of treatment are urgently required.[ citation needed]
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cite journal}}
: CS1 maint: multiple names: authors list (
link)
Infections of the hepatitis C virus (HCV) in children and pregnant women are less understood than those in other adults. Worldwide, the prevalence of HCV infection in pregnant women and children has been estimated to 1-8% and 0.05-5% respectively. [1] The vertical transmission rate has been estimated to be 3-5% and there is a high rate of spontaneous clearance (25-50%) in the children. Higher rates have been reported for both vertical transmission (18%, 6-36% and 41%). [2] [3] and prevalence in children (15%). [4]
In developed countries, transmission around the time of birth is now the leading cause of HCV infection. In the absence of virus in the mother's blood, transmission seems to be rare. [3] Factors associated with an increased rate of infection include membrane rupture of longer than 6 hours before delivery and procedures exposing the infant to maternal blood. [5] Cesarean sections are not recommended. Breastfeeding is considered safe if the nipples are not damaged. Infection around the time of birth in one child does not increase the risk in a subsequent pregnancy. All genotypes appear to have the same risk of transmission.
HCV infection is frequently found in children who have previously been presumed to have non-A, non-B hepatitis and cryptogenic liver disease. [6] The presentation in childhood may be asymptomatic or with elevated liver function tests. [7] While infection is commonly asymptomatic both cirrhosis with liver failure and hepatocellular carcinoma may occur in childhood.
Guidelines for the investigation of babies born to hepatitis C positive mothers have been published. [8]
Treatment of children has been with interferon and ribavirin. [9] The response to treatment is similar to that in adults. [10] It shows a similar dependence on the genotype. Recurrence after transplant is universal and the outcomes after transplant are usually poor. [11]
In children treatment should be initiated within 12 weeks of the detection of the viral RNA if viral clearance has not occurred within this time. [12] Given the difficulties with establishing a diagnosis of hepatitis C infection in infancy, this recommendation does not apply to infants.[ citation needed]
Both pegylated interferon and ribavirin are unsuitable for use in pregnancy and infancy: newer methods of treatment are urgently required.[ citation needed]
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)