My husband is hepatitis C positive. He is not ill. I knew this when we were married, and we decided we would take it one step at a time. Our doctors say the chance of me getting infected is about 5 percent, so we do not use any protection during intercourse. However, I unexpectedly got pregnant. I am now 21 weeks. Does hepatitis C cause any problems to the unborn baby? Is there is any test I can take to find out if the baby has been affected?

Sheri

hepatitis C is a very common infection in the United States. Most of the time, infection becomes chronic (persistent), with about 20-30 percent of patients developing end-stage liver disease after 20-30 years. Transmission of the hepatitis C virus (HCV) is through sex and contact with infected blood or body fluids. Until recently, hepatitis C was commonly caused by blood transfusion. Most people infected with HCV develop symptoms only after years of carrying the virus.

When one person is infected with HCV, there is about a 5 percent chance of transmitting the virus to his or her sexual partner. It is likely that condom use will prevent some of these cases. However, because of the relatively low likelihood of transmission, the United States Public Health Service has not recommended condom use between stable, monogamous partners.

HCV can be transmitted in the uterus from an infected mother to her baby. This risk also is estimated to be about 5 percent. While health authorities currently have no recommendations for any treatment to prevent this transmission, they do recommend that all babies born to HCV-infected mothers be screened for infection. This involves a blood test to detect evidence of HCV itself, rather than the usual method used for testing adults, which identifies antibodies made by the body in response to the virus. Since some of an infected mother's antibodies can pass from her to the fetus during pregnancy, it would be difficult to determine whether HCV antibodies in the baby's bloodstream were made by the immune system of the mother or the baby. The risk of breastfeeding seems to be very small, and the American Academy of Pediatrics does not recommend bottle-feeding by mothers infected with hepatitis C.

The risk to your baby seems to be much lower than 5 percent. You probably are not infected with hepatitis C, and if that is the case, there should be no risk to the baby at all. At worst, if you are infected, the risk of transmitting the virus to your child would be about 5 percent. You should be tested now. As I said above, there is no treatment recommended at this time to prevent prenatal transmission, but it would be comforting to know (if your test is negative) that your baby has no real risk of infection. The procedure involves only a simple blood test and poses absolutely no risk to you or your baby.