Perinatal hepatitis C concerns infants or children who are exposed to hepatitis C virus during pregnancy or childbirth [1]. It is characterized as infection acquired around the perinatal period rather than through other routes [1][2].
Disease overview
Evidence-backed information EN 5/7 applicable sections · ZH 5/7 applicable sections Updated Oct 23, 2026
Perinatal hepatitis C refers to HCV infection acquired by infants through exposure during pregnancy or childbirth, with maternal viremia serving as a recognized transmission risk [1][2]. Infection is often not clinically apparent in early infancy, underscoring the value of recommended testing to identify affected children [1]. Public-health guidance emphasizes antenatal testing and follow-up of exposed infants to avoid missed diagnoses [1].
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Infection may not be apparent in infancy, so testing is important to detect affected children and guide care [1]. Among children with perinatally acquired infection, spontaneous viral clearance occurs in a substantial proportion by age 5 years [1]. Although fetal infection was historically described as asymptomatic, isolated fetal ascites has been reported as a possible sole presenting sign in some HCV-exposed fetuses [2].
Maternal detectable HCV RNA is a known risk factor for perinatal transmission, and public-health recommendations address testing of exposed children [1]. Transmission from a viremic pregnant person to the infant at delivery occurs in an estimated 4%–7% of such cases [2]. Spontaneous clearance among perinatally infected children has been observed in roughly 20%–40% by age 5 years in earlier summaries, with more recent analyses suggesting clearance in the majority by that age [1].
HCV can pass from a pregnant person with viremic infection to an infant around birth, with delivery and exposure factors influencing risk [1]. Documented perinatal transmission rates are 4%–7% when detectable viremia is present at delivery [2]. Intrauterine transmission has also been suspected as a cause of isolated fetal ascites in the absence of other explanations [2].
Prevention of perinatal hepatitis C involves hepatitis C testing during pregnancy, appropriate pregnancy and delivery management, and timely testing of perinatally exposed infants to support prevention of missed infection and later complications [1].
- 1 US Centers for Disease Control and Prevention. CDC Recommendations for Hepatitis C Testing Among Perinatally Exposed Infants and Children â United States, 2023 | MMWR [Internet]. cited 23 Oct 2026. Available from: https://www.cdc.gov/mmwr/volumes/72/rr/rr7204a1.htm
- 2 Rădoi CL et al. Intrauterine Transmission of Hepatitis C Virus Concomitant with Isolated Severe Fetal Ascites. Pathogens. 2022 Nov 12. PMID: 36422587. doi: 10.3390/pathogens11111335. PubMed: https://pubmed.ncbi.nlm.nih.gov/36422587/
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