Thousands of babies born each year with hepatitis C infection
Study highlights importance of testing, researchers say
About 74,000 babies are born each year with the virus that causes hepatitis C, and more than 23,000 of them may still have the infection at age 5, a global study led by researchers at the University of Bristol found.
The virus can pass from mother to baby during pregnancy or childbirth — a route of transmission known as vertical transmission — but many women are unaware they are infected. Screening for hepatitis C during pregnancy and treating infected women could help prevent new infections.
“Our study findings highlight not only the scale of transmission, but also the great need for more testing,” Adam Trickey, PhD, the study’s first author and senior research fellow at the University of Bristol, said in a university press release. “Without this testing the virus, which can be cured in most cases, is left untreated in young children who contract the virus from birth.”
The study, “Estimating the annual number of hepatitis C virus infections through vertical transmission at country, regional, and global levels: a data synthesis study,” was published in The Lancet Gastroenterology & Hepatology coinciding with World Hepatitis Day.
Treatments are available, so why are people dying?
Hepatitis C is an inflammation of the liver caused by infection with the hepatitis C virus (HCV), which spreads through contact with contaminated blood and other bodily fluids. If left untreated, the disease can cause serious complications in the liver.
The World Health Organization estimates that some 240,000 people worldwide died from liver disease related to hepatitis C in 2022.
“This is despite highly effective treatments for HCV being available in many countries since 2014,” Trickey said. “These treatments involve a course of pills that need to be taken for around three months, with effective cure rates of more than 90%.”
Previous data suggest that HCV is passed from mother to baby in 7.2% of births. But while vertical transmission remains an important source of new infections with HCV, many women of childbearing age are unaware they are infected; hepatitis C often remains asymptomatic — meaning it causes no apparent symptoms — for years.
To estimate how many babies are born with the virus that causes hepatitis C, Trickey and other researchers in the U.K. and Canada combined the number of women aged 15-49 living with hepatitis C across 236 countries and territories.
Each year, an estimated 73,862 babies are born with hepatitis C through vertical transmission. The regions with the highest number of such infections are southern Asia (21,245), western Africa (16,482), and eastern Africa (8,182). These three regions together account for nearly two-thirds of all infections via vertical transmission.
Pakistan and Nigeria have the highest number of babies born with hepatitis C each year (16, 350 and 8,483, respectively), followed by China (3,983), Russia (3,941), and India (3,688). Together, these five countries account for nearly half of all vertically transmitted HCV infections worldwide.
Considering that about two-thirds of infected children naturally clear the virus in the first years of life, an estimated 23,120 children still have the infection by age 5.
But when the researchers used older, lower estimates of how many children clear the HCV, the number of children still living with the infection at that age more than doubled, reaching 52,386.
Health guidelines in the U.S. and Europe recommend screening all pregnant women for hepatitis C, but the practice remains rare, even in countries where it is officially recommended.
Direct-acting antivirals — the mainstay treatment for hepatitis C, which prevents the HCV from making copies of itself — generally cause few side effects, but their safety during pregnancy is still uncertain.
“Most guidelines do not advise for pregnant women with HCV to be treated because of a lack of evidence of the safety of these treatments, although a clinical trial is currently investigating this — preliminary results indicate high cure rates and few major side effects,” Trickey said.
“There is an urgent need to produce further evidence on the safety, efficacy, and cost-effectiveness of screening and HCV treatment of pregnant women and their children, so that policy makers can decide on the best route forward,” the researchers wrote.
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