Marina,

Nancy Wight MD has an article on the web on the perinatal transmission of
Hepatitis C that does a thorough literature review. Maybe this info will
help?

 http://www.breastfeeding.org/articles/hepatitis.html

The following article from the Lancet might also be useful.

Gibb, D. M., Goodall, R. L., Dunn, D. T., Healy, M., Neave, P., Cafferkey,
M., and Butler, K.,  "Mother-to-child transmission of hepatitis C virus:
evidence for preventable peripartum transmission," Lancet, Vol. 356, No.
9233, 2000, pp. 904-907.
Abstract: BACKGROUND: Little information is available about the timing of
mother- to-child transmission of hepatitis C virus (HCV), and no
interventions to decrease transmission rates have been identified. We
examined the effect of risk factors, including mode of delivery, on the
vertical transmission rate. METHODS: Data from HCV-infected women and their
infants from three hospitals in Ireland and from a British Paediatric
Surveillance Unit study of infants born to HCV-infected mothers were used to
estimate the vertical transmission rate and risk factors for transmission.
We used a probabilistic model using methods that simultaneously estimated
the time to HCV-antibody loss in uninfected infants and the diagnostic
accuracy of PCR tests for HCV RNA. FINDINGS: 441 mother-child pairs from the
UK (227) and Ireland (214) were included. 50% of uninfected children became
HCV-antibody negative by 8 months and 95% by 13 months. The estimated
specificity of PCR for HCV RNA was 97% (95% CI 96-99) and was unrelated to
age; sensitivity was only 22% (7-46) in the first month but rose sharply to
97% (85-100) thereafter. The vertical transmission rate was 6.7% (4.1-10.2)
overall, and 3.8 times higher in HIV coinfected (n=22) than in HIV-negative
women after adjustment for other factors (p=0.06). No effect of
breastfeeding on transmission was observed, although only 59 women
breastfed. However, delivery by elective caesarean section before membrane
rupture was associated with a lower transmission risk than vaginal or
emergency caesarean-section delivery (odds ratio 0 [0-0.87], p=0.04, after
adjustment for other factors). INTERPRETATION: The low sensitivity of HCV
RNA soon after birth and the finding of a lower transmission rate after
delivery by elective caesarean section suggest that HCV transmission occurs
predominantly around the time of delivery. If the findings on elective
caesarean section are confirmed in other studies, the case for antenatal HCV
testing should be reconsidered


Sara Bernard
The Netherlands

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