Vertical transmission of hepatitis C: towards universal antenatal screening in the era of new direct acting antivirals (DAAs)? Short review and analysis of the situation in Switzerland

At present, routine antenatal hepatitis C virus (HCV) screening is not recommended in pregnant women who do not have known risk factors for infection. The main reason for this attitude has been the lack of effective treatment options to avoid mother-to-child transmission (MTCT) during pregnancy or delivery. Hitherto available treatment regimens based on interferon (IFN) and ribavirin (RBV) were associated with sometimes long-lasting and severe side-effects and thus their indication had to be carefully evaluated. In addition, ribavirin has teratogenic and embryocidal effects and is absolutely contraindicated during pregnancy. The situation has substantially changed with the advent of the newly available treatment regimens based on very effective and well-tolerated direct-acting antiviral agents (DAAs). The aim of this viewpoint is to briefly analyse, using the example of Switzerland, how recent developments in HCV therapy might impact prevention of HCV vertical transmission.