The USPSTF researchers found no association between breastfeeding and HCV transmission,6 although the CDC recommends against the practice in HCV-infected women whose nipples are cracked or bleeding.5 Of note, both breastfeeding and cesarean delivery are associated with increased transmission risk among HCV/HIV coinfected women.7 HCV genotype is reported to have little impact on MTCT.1,10
Until the development of an effective HCV vaccine and safe, effective HCV treatment for pregnant patients,1,3 strategies to interrupt MTCT represent our best hope to protect children against HCV infection.
REFERENCES
1. Yeung CY, Lee HC, Chan WT, et al. Vertical transmission of hepatitis C virus: current knowledge and perspectives. World J Hepatol. 2014;6(9):643-651.
2. Benova L, Mohamoud YA, Calvert C, Abu-Raddad LJ. Vertical transmission of hepatitis C virus: systematic review and meta-analysis. Clin Infect Dis. 2014;59(6):765-773.
3. Prasad MR, Honegger JR. Hepatitis C virus in pregnancy. Am J Perinatol. 2013;30(2):149-159.
4. Arshad M, El-Kamary SS, Jhaveri R. Hepatitis C virus infection during pregnancy and the newborn period: are they opportunities for treatment? J Viral Hepat. 2011;18(4):229-236.
5. CDC. Hepatitis C FAQs for health professionals. www.cdc.gov/hepatitis/HCV/HCVfaq.htm. Accessed February 9, 2015.
6. Cottrell EB, Chou R, Wasson N, et al. Reducing risk for mother-to-infant transmission of hepatitis C virus: a systematic review for the US Preventive Services Task Force. Ann Intern Med. 2013;158(2):109-113.
7. Tosone G, Maraolo AE, Mascolo S, et al. Vertical hepatitis C virus transmission: main questions and answers. World J Hepatol. 2014;6(8):538-548.
8. Harvoni®: highlights of prescribing information. www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/harvoni/harvoni_pi.pdf. Accessed February 15, 2015.
9. Viekira Pak™: highlights of prescribing information. www.rxabbvie.com/pdf/viekirapak_pi.pdf. Accessed February 15, 2015.
10. Indolfi G, Resti M. Perinatal transmission of hepatitis C virus infection. J Med Virol. 2009;81(5):8836-843.
11. Mast EE, Hwang LY, Seto DS, et al. Risk factors for perinatal transmission of hepatitis C virus (HCV) and the natural history of HCV infection acquired in infancy. J Infect Dis. 2005;192:1880-1889.