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Pregnancy & Prenatal Testing

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Pre-Conception: Hepatitis B and Hepatitis C Screening

Infection with hepatitis viruses causes inflammation of the liver. People with acute hepatitis B or hepatitis C may have symptoms such as fatigue, nausea, and jaundice. Most people will get better without any intervention, but some may develop a chronic infection. Some of those chronically infected will have progressive liver damage that can lead to liver cancer and death.

Hepatitis B: the hepatitis B screening test is called hepatitis B surface antigen. It detects a protein produced by the virus and can detect a hepatitis B infection even before it causes symptoms. If a woman who is considering getting pregnant tests positive for hepatitis B, she should talk to her healthcare practitioner about how long she should wait to allow the infection to resolve before becoming pregnant.

It is important to detect active hepatitis B infections in pregnant women because newborns are especially vulnerable to developing chronic infection; up to 90% of those who become infected with hepatitis B in utero will become carriers. If a hepatitis infection is detected in a pregnant woman, she can be monitored and the baby can receive treatment at birth to minimize the risk of it developing hepatitis B.

A negative test for the virus means either that there is no current infection or there is not yet a sufficient amount of the antigen to be detected. If a woman participates in high-risk activities that may transmit the hepatitis B virus (such as unprotected sexual contact or intravenous drug use), retesting later in the pregnancy is generally advised.

Hepatitis C: though not common, hepatitis C can be passed from a mother to her baby. Screening of pregnant women is not routine but may be done if the mother is at risk of infection. Risk factors for hepatitis C include abusing intravenous drugs or having a sexual partner who abuses intravenous drugs, having a history of multiple sexually transmitted diseases, and being infected with hepatitis B.

Antibody tests are used to screen for the infection. Since the antibody test can remain positive in most people even if they have cleared the infection, a positive antibody test is followed by a hepatitis C RNA test, which detects genetic material of the virus. A positive result on the RNA test means the virus is present, the infection has not resolved, and the person may require treatment. The hepatitis C genotype test determines which type of virus is present to help guide treatment.

Centers for Disease Control and Prevention: Hepatitis B and Your Baby
American College of Obstetricians and Gynecologists: Hepatitis B and Hepatitis C in Pregnancy