Published online Sep 27, 2014. doi: 10.4254/wjh.v6.i9.643
Revised: July 12, 2014
Accepted: July 25, 2014
Published online: September 27, 2014
Hepatitis C virus (HCV) infection is a major global health issue. Infection by the HCV can cause acute and chronic liver diseases and may lead to cirrhosis, hepatocellular carcinoma or liver failure. The World Health Organization estimates that approximately 3% of the world population have been infected with HCV and the worldwide prevalence is between 1% and 8% in pregnant women and between 0.05% and 5% in children. Following the introduction of blood product screening, vertical transmission becomes the leading cause of childhood HCV infection. The prevalence of pediatric HCV infection varies from 0.05% to 0.36% in developed countries and between 1.8% and 5% in the developing world. All children born to women with anti-HCV antibodies should be checked for HCV infection. Though universal screening is controversial, selective antenatal HCV screening on high-risk populations is highly recommended and should be tested probably. Multiple risk factors were shown to increase the possibility of HCV vertical transmission, including coinfections with human immunodeficiency virus, intravenous drug use and elevated maternal HCV viral load, while breastfeeding and HCV genotypes have been studied to have little impact. At present, no clinical intervention has been clearly studied and proved to reduce the HCV vertical transmission risk. Cesarean section should not be recommended as a procedure to prevent vertical transmission, however, breastfeeding is generally not forbidden. The high prevalence of global HCV infection necessitates renewed efforts in primary prevention, including vaccine development, as well as new approaches to reduce the burden of chronic liver disease. Future researches should focus on the interruption of vertical transmission, developments of HCV vaccine and direct-acting antivirals in infancy and early childhood.
Core tip: Hepatitis C virus (HCV) infection is a major global health issue. World Health Organization estimates that the worldwide prevalence is 1%-8% in pregnant women and 0.05%-5% in children. Vertical transmission becomes the leading cause of childhood HCV infection. Current understanding of the epidemiology of mother-to-child transmission of HCV is limited. At present, no clinical intervention has been clearly studied and proved to reduce the vertical transmission risk. Though universal screening is controversial, selective antenatal HCV screening on high-risk populations is highly recommended and should be tested probably. This review provides the current knowledge and perspectives of HCV vertical transmission and summarizes the updated follow up guidelines for clinical practice.