Symptoms of hepatitis C infection can include abdominal pain, nausea, weight loss, fatigue, and jaundice (yellowing of the skin and eyes caused by liver cell damage). In most cases, however, hepatitis C causes no symptoms.

In less than half of the people who have hepatitis C who don’t receive treatment, the virus goes away by itself within 6 months. In the rest of those infected, the virus does not go away. This is called chronic infection. Chronic infection can lead to cirrhosis, a serious and permanent liver disease; liver failure; and liver cancer. People with chronic HCV infection can also pass the virus to others.

Yes. A blood test can show whether a person has hepatitis C. It looks for antibodies made by the immune system against the virus. If HCV antibodies are found, another test, called an HCV RNA test, is done. This test measures the amount of RNA, the genetic material of the virus, in a person’s blood. All pregnant people should be tested for HCV.

New antiviral medications for chronic hepatitis C have been developed in recent years. Many people who receive this treatment are cured. This means no virus can be found in the blood 3 months after completing treatment. Currently, however, treatment for HCV is not recommended during pregnancy (see below).

Pregnant people with hepatitis C are more likely to develop problems that can affect their health and that of the fetus, including diabetes during pregnancy and a liver disease called intrahepatic cholestasis of pregnancy (ICP). Babies born to people with HCV may be smaller than average and are more likely to be born early. However, it is not clear whether these problems are caused by hepatitis C or by other factors.

Yes, HCV can pass to the fetus during pregnancy. The risk of this happening is about 5%. The risk is higher (about 10%) when the pregnant person has both hepatitis C and human immunodeficiency virus (HIV) infections. HCV is more likely to pass to the fetus if a pregnant person has HCV RNA in their blood, but it is a concern for all pregnant people with HCV infection.

There is not much information about how medications used to treat HCV affect a developing fetus. Research is currently being done to study the safety of HCV treatment during pregnancy. Until more safety information is available, treatment of HCV with antiviral medication is not recommended during pregnancy.

Pregnant people with hepatitis C should have an HCV RNA test to measure the amount of virus in their blood. Other testing should be done to assess how the liver is functioning. Screening for other infections, such as HIV and hepatitis A and B, may also be recommended. Vaccination against hepatitis A and B is recommended during pregnancy if a person is found to be susceptible to these diseases.

If you have hepatitis C and have not already seen a liver or infectious disease specialist, you may want to do so during pregnancy. A specialist can evaluate your health and set up a long-term care plan, which may include taking antiviral medication after your pregnancy.

You should not drink alcohol if you have HCV infection, whether you are pregnant or not. Alcohol can increase the risk of liver damage.

It is possible, although not very likely, that having tests such as amniocentesis or chorionic villous sampling (CVS) could increase the risk of passing HCV to the fetus. However, the chances of this happening are very small.

You can plan to deliver your baby vaginally if you have hepatitis C. Cesarean delivery has not been shown to prevent or reduce transmission of HCV to the baby.

Babies born to people with hepatitis C should be tested for HCV. Testing the baby for HCV can be done in one of two ways:

1.     An HCV antibody test after the baby turns 18 months old.

2.     Two separate HCV RNA tests after the baby turns 1 month old.

Yes. There is little to no risk of passing HCV to your baby through breastfeeding unless your nipples are cracked or bleeding. If you have cracked or bleeding nipples, milk should be expressed and then thrown away and not fed to the baby. You can return to breastfeeding after your nipples have healed.