Hepatitis C cure journey in pregnancy

Overview

Hepatitis C is a virus that infects the liver. For pregnant women, the 'cure journey' means managing the infection during pregnancy and planning for treatment after the baby is born, because the most effective medicines are not used during pregnancy.

Hepatitis C is not common in pregnancy, but it does affect a small number of pregnant women, especially those with certain risk factors.

It primarily affects pregnant women who have been in contact with infected blood, for example through injection drug use, blood transfusions before 1992, or needlestick injuries.

Symptoms

Common symptoms

• Many people have no symptoms at all.
• Feeling very tired (fatigue)
• Mild pain in the upper right side of the belly

Symptoms in children

• Most newborns with hepatitis C show no symptoms.
• Rarely, they may have poor feeding or jaundice (yellowing of the skin/eyes).

Symptoms in older adults

• Fatigue may be more severe.
• Confusion or memory problems (if liver damage is advanced).

Causes

Main causes

• Infection with the hepatitis C virus, which is spread through blood-to-blood contact.

Risk factors

• Using injected drugs (even once long ago)
• Receiving a blood transfusion or organ transplant before 1992
• Being born to a mother with hepatitis C
• Accidental needle stick in healthcare work
• Having a tattoo or piercing with unsterile equipment

When to see a doctor

See a doctor urgently if:

• If you have any emergency symptoms listed above.
• If you think you have been exposed to hepatitis C recently.

Book a routine appointment if:

• If you are pregnant and have any risk factors, ask your midwife or doctor for a blood test.
• If you have been told you have hepatitis C and are planning a pregnancy.

Diagnosis

A blood test checks for antibodies to the hepatitis C virus. If positive, a second test (PCR) looks for the virus itself to confirm an active infection.

Tests that may be done

• Hepatitis C antibody test (first screening)
• Hepatitis C RNA test (confirms active virus)
• Liver function tests to check liver health

What to expect at your appointment

The blood tests are simple and fast. Results usually come back within a week. Your healthcare provider will explain what they mean and discuss next steps.

Treatment

Treatment for hepatitis C is very effective, but it is usually delayed until after pregnancy because the standard medicines (called direct-acting antivirals) are not recommended during pregnancy. The goal is to keep you and your baby healthy during pregnancy and then treat the infection after delivery.

Self-care at home

• Avoid alcohol completely – it can harm your liver.
• Eat a balanced diet with plenty of fruits and vegetables.
• Get enough rest and manage stress.
• Attend all prenatal appointments so your healthcare team can monitor your liver and your baby's growth.

Medical treatments

After your baby is born, your healthcare provider may offer a course of oral antiviral medication that lasts 8 to 12 weeks. These medications cure more than 95% of people with very few side effects. You and your doctor will decide together when to start treatment.

When is surgery considered?

Surgery is rarely needed for hepatitis C. Only if the liver becomes severely damaged may a liver transplant be considered, but this is very uncommon during pregnancy.

Living with this condition

During pregnancy, focus on staying healthy: eat well, rest, and avoid alcohol. You can continue your usual activities unless you feel very tired. Your healthcare team will monitor you closely.

Lifestyle tips

• Do not share needles, razors, or toothbrushes.
• Use condoms with new partners (though the risk of sexual transmission is low).
• Keep all medical appointments – both prenatal and liver-related.

Diet and exercise

Eat a healthy diet with plenty of vegetables, lean protein, and whole grains. Stay active with gentle exercise like walking or prenatal yoga, as approved by your doctor.

Mental health and emotional wellbeing

It is normal to worry about passing the virus to your baby or about your own health. Talk to your midwife or doctor about these fears. You are not alone, and support is available.

Prevention

Hepatitis C can be prevented by avoiding contact with infected blood. There is no vaccine, but you can reduce risk by not sharing needles or personal items that might have blood on them.

Vaccines

There is currently no vaccine for hepatitis C.

Screening programmes

Pregnant women with risk factors should be offered a blood test for hepatitis C early in pregnancy so that the infection can be managed properly.

Complications

If left untreated

• Liver damage over many years (cirrhosis)
• Increased chance of passing hepatitis C to your baby (around 5 in 100 without treatment)
• Rarely, liver cancer decades later

Long-term outlook

The outlook is very good. Most people with hepatitis C can be completely cured after pregnancy. With modern care, the risk to you and your baby is low, and you can look forward to a healthy future.

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