Hepatitis C is an RNA virus. It is mainly spread through blood-to-blood contact, such as sharing injecting equipment. No vaccine is available. It is curable with direct-acting antiviral treatment, available from age 3.
Vertical Transmission
Hepatitis C is passed from mothers with detectable HCV RNA to their babies around 5% of the time, depending on the mother’s viral load. The risk is significantly higher if the mother also has HIV.
Ideally, women should be treated before becoming pregnant. Hepatitis C antivirals are not recommended in pregnancy. There is no vaccine or immunoglobulin to reduce vertical transmission, and caesarean section is not recommended solely to reduce transmission. Avoiding invasive fetal monitoring and unnecessary prolonged rupture of membranes may reduce blood exposure.
The hepatitis C antibody test is not reliable until 18 months of age, as maternal antibodies may still be present. Hepatitis C RNA testing can be performed earlier in infancy (e.g., from 2 months) to detect infection.
Breastfeeding has not been found to spread hepatitis C. If nipples become cracked or bleed, breastfeeding should temporarily stop while they heal.
About 25–40% of vertically infected children spontaneously clear hepatitis C by around 4 years of age. The remainder develops chronic hepatitis C infection.
Management in Children
Most babies and children are asymptomatic and have little liver disease during childhood. Infected children require regular specialist follow-up to monitor their liver function and hepatitis C viral load.
Day-to-day household and school contact does not spread HCV. Parents should be educated about hepatitis C and its modes of transmission, for example, by avoiding sharing toothbrushes or razors and by covering bleeding wounds.
Direct-acting antiviral treatment is available from age 3, under specialist care. These are highly effective and usually clear the virus.
Long-term risks of chronic, untreated infection include liver cirrhosis and hepatocellular carcinoma.
Last updated May 2026
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