Hepatitis C: screening in pregnancy

Hepatitis C virus infection, which is far more prevalent than human immunodeficiency virus (HIV)-1, can lead to cirrhosis, hepatocellular carcinoma, hepatic failure, and death. Like HIV-1, hepatitis C is transmitted parenterally, sexually, and from mother to infant. The American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) recently recommended that all children born to women who are infected with hepatitis C virus or have risk factors for infection be screened for hepatitis C. Most infected women are asymptomatic and unaware of their infection, so routine prenatal testing is needed to fully meet that goal. We do not believe that current data justify universal testing, but we believe it is time for all obstetricians to test selectively based on risk factors.