Mother-to-infant transmission of hepatitis C virus

Since the programme of the hepatitis B virus vaccination started, hepatitis C virus has become the most significant cause of chronic liver disease of infectious aetiology in paediatric age. After the introduction of hepatitis C virus screening of blood units, vertical transmission seems to now be th e most common route of hepatitis C virus infection in children. According t o studies on infants born to anti-hepatitis C virus positive women, the rat e of mother-to-infant transmission is about 5% when the mother is anti-hepa titis C virus positive and anti-MN negative, but the risk is three-five tim es higher when the mother is coinfected with HIV Both viral and host relate d factors are of importance as risk factors in vertical hepatitis C virus t ransmission. Among the first, only viral load has been demonstrated by some authors as a relevant risk factor while genotype seems not to be influent. The importance of quasispecies has been hypothesized but not yet clarified Among host-related factors, beyond maternal HN coinfection, maternal drug abuse has certainly an important role. Other factors such as breastfeeding and vaginal delivery do not seem to influence the rare of vertical transmis sion. Progression to chronicity occurs in the majority of perinatally infec ted children, although hepatitis C virus associated liver disease is usuall y mild throughout infancy and childhood.