Journal
VIRUSES-BASEL
Volume 4, Issue 12, Pages 3531-3550Publisher
MDPI
DOI: 10.3390/v4123531
Keywords
Hepatitis C virus; pathogenesis; mother-to-child transmission; pediatrics
Categories
Funding
- Canadian Institutes of Health Research (CIHR)
- Reseau SIDA et maladies infectieuses of le Fonds de la recherche du Quebec-Sante (FRQS)
- CIHR
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The worldwide prevalence of HCV infection is between 1% and 8% in pregnant women and between 0.05% and 5% in children. Yet the pathogenesis of hepatitis C during pregnancy and in the neonatal period remains poorly understood. Mother-to-child transmission (MTCT), a leading cause of pediatric HCV infection, takes place at a rate of <10%. Factors that increase the risk of MTCT include high maternal HCV viral load and coinfection with HIV-1 but, intriguingly, not breastfeeding and mode of delivery. Pharmacological prevention of MTCT is not possible at the present time because both pegylated interferon alfa and ribavirin are contraindicated for use in pregnancy and during the neonatal period. However, this may change with the recent introduction of direct acting antiviral agents. This review summarizes what is currently known about HCV infection during pregnancy and childhood. Particular emphasis is placed on how pregnancy-associated immune modulation may influence the progression of HCV disease and impact MTCT, and on the differential evolution of perinatally acquired HCV infection in children. Taken together, these developments provide insights into the pathogenesis of hepatitis C and may inform strategies to prevent the transmission of HCV from mother to child.
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