This is a single-stranded RNA virus, and transmission occurs via blood and body luids, although sexual transmission is ineicient. Up to a third of anti-HCV positive persons have no identifiable risk factors (Dienstag, 2015b). Screening for HCV is recommended for HIV-infected individuals, persons with injection drug use, hemodialysis patients, children born to mothers with HCV, persons exposed to HCV-positive blood or body fluids, persons with unexplained elevations in transaminase values, and recipients of blood or transplants before July 1992. Prenatal screening is recommended for high-risk women, and in the United States, seroprevalence rates reach 1 to 2.4 percent (American College of Obstetricians and Gynecologists, 2016; Arshad, 2011). It is higher in women who are infected with HIV. Santiago-Munoz and associates (2005) found that 6.3 percent of HIV-infected pregnant women at Parkland Hospital were co-infected with hepatitis B or C.
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Acute HCV infection is usually asymptomatic or yields mild symptoms. Only 10 to 15 percent develop jaundice. he incubation period ranges from 15 to 160 days with a mean of 7 weeks. Transaminase levels are elevated episodically during the acute infection. Hepatitis C RNA testing is now preferred for HCV diagnosis. RNA levels may be found even before elevations of transaminase and anti-HCV levels. Speciically, anti-HCV antibody is not detected for an average of 15 weeks and in some cases up to a year (Dienstag, 20 15a).
Nearly 80 to 90 percent of patients with acute HCV will be chronically infected. Although most remain asymptomatic, approximately 20 to 30 percent progress to cirrhosis within 20 to 30 years. Transaminase values fluctuate, and HCV RNA levels vary over time. Liver biopsy reveals chronic disease and fibrosis in up to 50 percent, however, these indings are oten mild. Overall, the long-term prognosis for most patients is excellent.
As expected, most pregnant women diagnosed with HCV have chronic disease. HCV infection was initially thought to have limited pregnancy efects. However, more recent reports have chronicled modestly increased fetal risks for low birthweight,
NICU admission, preterm delivery, and mechanical ventilation (Berkley, 2008; Pergam, 2008; Reddick, 201l). In some women, high-risk behaviors associated with HCV infection.