Hepatitis C is an RNA virus. It is most commonly transmitted between drug users who share needles. It has a relatively long incubation period of one to 10 weeks, meaning that it takes this long after the virus enters the body for symptoms to develop. However, acute symptoms of this infection are generally of less concern than the development of chronic liver disease, which occurs in about one half of those infected.
Who's at Risk?
The principal risk factors for hepatitis C are:
- intravenous drug abuse;
- blood transfusion;
- concurrent hepatitis B infection; and
- sexual intercourse with an infected partner.
Approximately 90% of all cases of post-transfusion hepatitis are due to hepatitis C, and 2.5 to 15.0% of patients who receive multiple transfusions become infected with this virus.
What Are the Symptoms and Consequences of Hepatitis C Infection?
Most patients with hepatitis C (about 75%) show no symptoms in the initial stages of illness. In those who do, the symptoms are those common to all varieties of viral hepatitis-such as nausea, fatigue, poor appetite, fever, and jaundice. Unfortunately, however, about 50% of patients who contract hepatitis C subsequently develop chronic liver disease. Chronic active hepatitis and cirrhosis are particularly severe forms of permanent liver injury. Liver damage as the result of hepatitis C infection accounts for the greatest need for liver transplants in the
What Are the Special Risks of Hepatitis C Infection in Pregnancy?
Hepatitis C affects 1 to 3% of pregnant mothers in the The following women are most at risk:
- pregnant women with sexually transmitted diseases (STDs), such as hepatitis B and HIV infection;
- those with multiple sexual partners;
- those with recent multiple blood transfusions; and
- those with a history of intravenous drug abuse.
The frequency of viral transmission to the baby is highly variable. In women who have unusually high concentrations of hepatitis C in their blood or who are infected with both hepatitis C and the human immunodeficiency virus (HIV), the transmission rate may be as high as 40%. In other patients, the rate of transmission is around 10%.
Certain obstetric interventions, like early rupture of the fetal membranes, placement of fetal scalp electrode, or fetal scalp blood sampling are avoided in the presence of hepatitis C.
In women with HIV, elective cesarean section has been shown to reduce the rate of hepatitis C transmission as well as HIV transmission. However, the utility of cesarean delivery to minimize hepatitis C transmission in the absence of HIV has not been determined. Further studies, especially of the role of viral load, are needed to satisfy this question.
Although transmission of hepatitis C by breastfeeding has not been proven, there is a theoretical risk of infection in the breastfed infant. Given the wide availability of safe alternatives to breastfeeding, the practice is often discouraged in the .