Review
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World J Hepatol. Sep 27, 2014; 6(9): 643-651
Published online Sep 27, 2014. doi: 10.4254/wjh.v6.i9.643
Vertical transmission of hepatitis C virus: Current knowledge and perspectives
Chun-Yan Yeung, Hung-Chang Lee, Wai-Tao Chan, Chun-Bin Jiang, Szu-Wen Chang, Chih-Kuang Chuang
Chun-Yan Yeung, Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
Chun-Yan Yeung, Hung-Chang Lee, Wai-Tao Chan, Chun-Bin Jiang, Szu-Wen Chang, Division of Gastroenterology and Nutrition, Department of Pediatrics, Mackay Memorial Hospital, Taipei 10449, Taiwan
Chun-Yan Yeung, Wai-Tao Chan, Institute of Biotechnology and Department of Chemical Engineering, National Taipei University of Technology, Taipei 10608, Taiwan
Chun-Yan Yeung, Chun-Bin Jiang, Department of Nursing, Mackay Junior College of Medicine, Nursing and Management, Taipei 10449, Taiwan
Hung-Chang Lee, Department of Pediatrics, Taipei Medical University, Taipei 10449, Taiwan
Chih-Kuang Chuang, Department of Medical Research, Mackay Memorial Hospital, Taipei 10449, Taiwan
Chih-Kuang Chuang, College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan
Author contributions: Yeung CY contributed to conception, drafting of the article, literature review and approved the final version of the article; Lee HC, Chan WT, Jiang CB and Chang SW contributed to drafting of the article and literature review; Chuang CK contributed to conception, drafted the article, critically reviewed the manuscript and approved the final version of this article.
Correspondence to: Chih-Kuang Chuang, MSc, PhD, Department of Medical Research, Mackay Memorial Hospital, No.92, Sec.2, Chung Shan North Road, Taipei 10449, Taiwan. cyyeung@mmh.org.tw
Telephone: +886-2-25433535 Fax: +886-2-25433642
Received: December 5, 2013
Revised: July 12, 2014
Accepted: July 25, 2014
Published online: September 27, 2014
Processing time: 318 Days and 0.1 Hours
Abstract

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.

Keywords: Hepatitis C virus; Vertical transmission; Perinatal infection; Chronic liver disease

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.