Perinatal Consequences of Hepatitis C

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Abstract
Hepatitis C virus (HCV) is a specific causative agent of what was formerly known as "non-A, non-B hepatitis." Once thought to be a disease of little significance, HCV now is recognized as the most common cause of posttransfusion and chronic viral hepatitis in the Western world and ranks only slightly below chronic alcoholism as a cause of cirrhosis, endstage liver disease, and hepatocellular carcinoma in the United States.1,2 Infection by HCV is often silent and only discovered by serologic screening such as occurs during blood donation or routine health screening. The recent discovery of the HCV genome in 1989 by Choo et al3 has led to the development of diagnostic tests and a better understanding of the natural history of this disease. Although HCV infection causes less acute disease than does hepatitis B, it accounts for twice as many deaths. Costs for treatment because of HCV infection are estimated to be $600 million per year.4 Hepatitis C virus also has been shown to be vertically transmitted to infants, making this disease of particular significance to the obstetrician.5,6 The economic burden of progressive disease to the mother as well as the potential for maternal-fetal transmission emphasizes the importance of preventative measures and early identification and treatment of HCV. This article will review the epidemiology, diagnosis, and treatment of hepatitis C. Emphasis will be placed on recommendations for screening and counseling pregnant women diagnosed with HCV.