Risk Factors For Vertical Transmission Research Articles

Viral load non-suppression status among women exposed to Dolutegravir-based versus Efavirenz-based regimens in Ethiopia: A before-and-after study.

High viral load during pregnancy and breastfeeding period is the risk factor for vertical transmission of human immunodeficiency virus (HIV). Currently, Dolutegravir (DTG)-based regimens are recommended to attain adequate viral load suppression (VLS) among women. However, its effect on VLS has not been investigated among women in PMTCT care in Ethiopia. This study aimed to investigate the rate of viral load non-suppression among women exposed to DTG-based versus Efavirenz (EFV)-based regimens in Ethiopia. An uncontrolled before-and-after study design was conducted among 924 women (462 on EFV-based and 462 on DTG-based regimens) enrolled in PMTCT care from September 2015 to February 2023. The outcome variable was the viral load (VL) non-suppression among women on PMTCT care. A modified Poisson regression model was employed, and the proportion was computed to compare the rate of VL non-suppression in both groups. The risk ratio (RR) with a 95% confidence interval (CI) was calculated to assess viral load non-suppression among women on DTG-based and EFV-based regimens by adjusting for other variables. The overall rate of non-suppressed VL was 16.2% (95% CI: 14.0-18.8%). Mothers on DTG-based regimens had approximately a 30% (adjusted risk ratio (aRR): 0.70; 95% CI: 0.52-0.94) lesser risk of developing non-suppressed VL than women on EFV-based regimens. Besides, older women were 1.38 times (aRR: 1.38; 95% CI: 1.04-1.83); mothers who did not disclose their HIV status to their partners were 2.54 times (aRR: 2.54; 95% CI: 1.91-3.38); and mothers who had poor or fair adherence to antiretroviral (ARV) drugs were 2.11 times (aRR: 2.11; 95% CI: 1.45-3.07) at higher risk of non-suppressed VL. Women on DTG-based regimens had a significantly suppressed VL compared to those on EFV-based regimens. Thus, administering DTG-based first-line ART regimens should be strengthened to achieve global and national targets on VLS.

Vertical Transmission of Hepatitis B Virus—An Update

Hepatitis B virus (HBV) infection is a major public health problem in the world. Approximately 296 million people are chronically infected. In endemic areas, vertical transmission is a common route of transmission. There are several strategies for the prevention of HBV vertical transmission, such as antiviral treatment during the third trimester of pregnancy and immunoprophylaxis to newborns that includes the administration of hepatitis B immune globulin (HBIG) and an HBV vaccine. Despite this, immunoprophylaxis failure can occur in up to 30% of infants born to HBeAg-positive mothers and/or with high viral load. Therefore, management and prevention of HBV vertical transmission is of paramount significance. In this article, we provided a review of the epidemiology, mechanisms of pathogenesis and risk factors of vertical transmission, as well as the strategies implemented to prevent the infection.

RISKS OF MOTHER-TO-CHILD TRANSMISSION OF HIV

Vertical transmission is a condition in which the virus is infected from mother to child and can have some consequences and risks during pregnancy and at the time of delivery. It is estimated that the incidence of vertical transmission occurs in 25% of pregnancies of infected women when there are no prophylactic measures and therapeutic interventions, resulting in high rates of mortality and disease progression. Contact with contaminated fluids can lead children to contract the virus in the first few months of life. The factors involved include several failures in the health system and maternity. Thus, the present study is based on the following justification: In health services and in the social context, there are difficulties and gaps that contribute to the risk factors of vertical transmission of HIV, constituting negative results for the control of the disease. In view of this, the objective of this research is to identify in the literature which are the existing difficulties that influence the prophylactic measures of vertical transmission. This study was carried out through an integrative literature review, through a survey of data in the scientific bases: LILACS, SCIELO and BDENF. The results obtained indicate that the failure to take prophylactic measures during pregnancy, due to negligence in prenatal consultations, is considered one of the aggravating factors for the risk of VT. Without early diagnosis, without knowledge of the virus, the pregnant woman does not undergo treatment with antiretroviral medication, with this, the immune system is more vulnerable to weakening and risks of complications during pregnancy.

Population-level risk factors for vertical transmission of HIV in the national prevention of mother-to-child transmission programme in South Africa: An ecological analysis

Background. Although South Africa has an overall mother-to-child transmission (MTCT) of HIV rate <5%, case rates remain high. Objectives. To identify population-level predictors of MTCT to inform targeted interventions to further reduce paediatric HIV incidence. Methods. The study was an ecological analysis of routine laboratory HIV-related test data from a synthetic cohort of women of reproductive age living with HIV (WRLHIV), identified from the National Health Laboratory Service’s Corporate Data Warehouse between 2016 and 2017. Criteria based on syphilis screening and timing of HIV-related tests were used to identify pregnant and non-pregnant WRLHIV. Pregnant WRLHIV were followed from cohort entry at the first antenatal care (fANC) visit, through delivery to exit at the latest viral load (VL) or 15 months post delivery. Follow-up for non-pregnant WRLHIV started at cohort entry on 1 January 2016 to exit at the latest VL or 31 December 2018. HIV VL tests performed at cohort entry, delivery and cohort exit described viraemia (VL ≥50 copies/mL) at subdistrict level. A negative binomial regression model determined the association between MTCT cases and the number of viraemic WRLHIV at different time points, controlling for number of WRLHIV aged <25 years at cohort entry and other routine HIV-related indicators at subdistrict level. Results. Of 3 386 507 WRLHIV identified, 178 319 (5.3%) met criteria for pregnancy. Median (interquartile range (IQR)) proportions of women with fANC booking <20 weeks’ gestation, maternal HIV seroprevalence during antenatal care (ANC) and antiretroviral therapy (ART) coverage during ANC were 68.2% (62.9 - 72.8), 31.5% (23.4 - 35.7) and 94.8% (89.7 - 97.8), respectively. Viraemia was consistently higher in pregnant v. non-pregnant WRLHIV at median proportions of 42.9% (38.3 - 59.3) v. 35.0% (25.9 - 49.0) at cohort entry (p<0.001) and 36.3% (25.0 - 48.4) v. 29.6% (21.0 - 42.6) at cohort exit (p<0.001). In total, 4 535 children aged <24 months tested HIV polymerase chain reaction-positive, representing a median subdistrict-level case rate of 1 372 (914 - 2 077) per 100 000 live births. Maternal viraemia postpartum, maternal HIV seroprevalence and ART coverage during ANC positively correlated with cases of MTCT, while higher proportions of women with fANC booking <20 weeks’ gestation were associated with a decline in MTCT cases. Conclusions. Findings suggest that maternal viraemia postpartum, geographical areas with a higher burden of maternal HIV, women initiating ART late in pregnancy and/or incident maternal HIV during pregnancy are significant population-level predictors of MTCT in the national prevention of MTCT programme. Scale-up of HIV prevention services is required to lower maternal HIV prevalence, while expanded access to HIV testing will fast-track ART initiation among WRLHIV. Increased VL monitoring is critical to improve VL suppression rates for elimination of MTCT.

Maternal Human Immunodeficiency Virus (HIV) Drug Resistance Is Associated With Vertical Transmission and Is Prevalent in Infected Infants.

We aimed to assess if maternal human immunodeficiency virus (HIV) drug resistance is associated with an increased risk of HIV vertical transmission and to describe the dynamics of drug resistance in HIV-infected infants. This was a case-control study of PROMISE study participants. "Cases" were mother-infant pairs with HIV vertical transmission during pregnancy or breastfeeding and "controls" were mother-infant pairs without transmission matched 1:3 by delivery date and clinical site. Genotypic HIV drug resistance analyses were performed on mothers' and their infants' plasma at or near the time of infant HIV diagnosis. Longitudinal analysis of genotypic resistance was assessed in available specimens from infants, from diagnosis and beyond, including antiretroviral therapy (ART) initiation and last study visits. Our analyses included 85 cases and 255 matched controls. Maternal HIV drug resistance, adjusted for plasma HIV RNA load at infant HIV diagnosis, enrollment CD4 count, and antepartum regimens, was not associated with in utero/peripartum HIV transmission. In contrast, both maternal plasma HIV RNA load and HIV drug resistance were independent risk factors associated with vertical transmission during breastfeeding. Furthermore, HIV drug resistance was selected across infected infants during infancy. Maternal HIV drug resistance and maternal viral load were independent risk factors for vertical transmission during breastfeeding, suggesting that nevirapine alone may be insufficient infant prophylaxis against drug-resistant variants in maternal breast milk. These findings support efforts to achieve suppression of HIV replication during pregnancy and suggest that breastfeeding infants may benefit from prophylaxis with a greater barrier to drug resistance than nevirapine alone.

Prevention of vertical transmission of hepatitis B virus infection.

Hepatitis B virus (HBV) is the leading cause of chronic viral hepatitis. Annually, almost two million children younger than 5 years acquire the infection, mostly through vertical or horizontal transmission in early life. Vertical transmission of HBV is a high efficacy phenomenon ranging, in the absence of any preventive interventions, from 70% to 90% for hepatitis e antigen positive mothers and from 10% to 40% for hepatitis e antigen-negative mothers. Maternal viraemia is a preeminent risk factor for vertical transmission of HBV. Maternal screening is the first step to prevent vertical transmission of HBV. Hepatitis B passive and active immunoprophylaxis at birth together with antiviral treatment of highly viraemic mothers are the key strategies for global elimination of HBV infection. Strategies are needed to promote implementation of birth-dose vaccination and hepatitis B immunoglobulins in low- and middle-income countries where the prevalence of the infection is at the highest.

Low Maternal Immunoglobulin G Avidity and Single Parity as Adverse Implications of Human Cytomegalovirus Vertical Transmission in Pregnant Women with Immunoglobulin M Positivity.

Human cytomegalovirus (CMV) is the leading cause of neurological sequelae in infants. Understanding the risk factors of primary CMV infection is crucial in establishing preventive strategies. Thus, we conducted a retrospective cohort study to identify risk factors of vertical transmission among pregnant women with immunoglobulin (Ig) M positivity. The study included 456 pregnant women with IgM positivity. Information on age, parity, occupation, clinical signs, IgM levels, and IgG avidity index (AI) was collected. The women were divided into infected and non-infected groups. The two groups showed significant differences in IgM level, IgG AI, number of women with low IgG AI, clinical signs, and number of pregnant women with single parity. In the multiple logistic regression analysis, pregnant women with single parity and low IgG AI were independent predictors. Among 40 women who tested negative for IgG antibody in their previous pregnancy, 20 showed low IgG AI in their current pregnancy. Among the 20 women, 4 had vertical transmission. These results provide better understanding of the risk factors of vertical transmission in pregnant women with IgM positivity.

32. Risk Factors for Vertical Transmission of t. Cruzi infection in an Endemic Setting

Members of the Chagas Disease Working Group in Peru and Bolivia includeEdith Hinojosa, Clariza Chavez, Jean Karla Velarde, Carla Chavarria, Victoria Serrudo, Roberto Araya, Alcides Buitron, Rita Mendieta, Holger Mayta, Maritza Calderon, Holger Mayta and Yagahira Castro.BackgroundVertical transmission of Trypanosoma cruzi infection accounts for a growing proportion of new cases of Chagas disease. Congenital infection is curable if treated promptly, but the majority of infected infants do not receive timely diagnosis or treatment. Better risk stratification is needed to predict which women are more likely to transmit the infection.MethodsThis study enrolled women who presented for delivery and their infants at the Percy Boland Women’s Hospital in Santa Cruz, Bolivia. Pregnant women were screened for Chagas disease by rapid test. The infants of seropositive mothers underwent diagnostic testing with microscopy (“micromethod”) and quantitative polymerase chain reaction (qPCR) as newborns and at one- and nine-month follow-up. Mothers completed surveys about demographics and medical history.ResultsAmong 5,828 enrolled women, 1,271 (21.8%) screened positive for Chagas disease. Of the 1,325 infants of seropositive mothers, 113 (8.5%) were diagnosed with congenital Chagas disease by microscopy or qPCR. Cesarean delivery was significantly associated with lower odds of vertical transmission (adjusted OR: 0.63, 95% CI: 0.41–0.98, p=0.040). Congenital infection was more common in twins (adjusted OR: 3.30, 95% CI: 1.97–5.54, p< 0.001) and male infants (adjusted OR: 1.50, 95% CI: 1.01–1.22, p=0.045).ConclusionOur findings suggest that Cesarean delivery may be protective against vertical transmission of T. cruzi, while twins and male infants may have an increased risk. A better understanding of risk stratification for congenital Chagas disease may help improve regional initiatives to reduce disease burden.Disclosures All Authors: No reported disclosures

Seroprevalence and epidemiology of hepatitis B and C viruses in pregnant women in Spain. Risk factors for vertical transmission

Worldwide, measures are being implemented to eradicate hepatitis B (HBV) and C (HCV) viruses, which can be transmitted from the mother during childbirth. This study aims to determine the prevalence of HBV and HCV in pregnant women in Spain, focusing on country of origin, epidemiological factors and risk of vertical transmission (VT). Multicentre open-cohort study performed during 2015. HBV prevalence was determined in 21870 pregnant women and HCV prevalence in 7659 pregnant women. Epidemiological and risk factors for VT were analysed in positive women and differences between HBV and HCV cases were studied. HBV prevalence was 0.42% (91/21870) and HCV prevalence was 0.26% (20/7659). Of the women with HBV, 65.7% (44/67) were migrants. The HBV transmission route to the mother was unknown in 40.3% of cases (27/67) and VT in 31.3% (21/67). Among risk factors for VT, 67.7% (42/62) of the women had viraemia and 14.5% (9/62) tested HBeAg-positive. All of the neonates born to HBV-positive mothers received immunoprophylaxis, and none contracted infection by VT. In 80% (16/20) of the women with HCV, the transmission route was parenteral, and nine were intravenous drug users. Viraemia was present in 40% (8/20) of the women and 10% (2/20) were HIV-coinfected. No children were infected. Women with HCV were less likely than women with HBV to breastfeed their child (65% vs. 86%). The prevalences obtained in our study of pregnant women are lower than those previously documented for the general population. Among the women with HBV, the majority were migrants and had a maternal family history of infection, while among those with HCV, the most common factor was intravenous drug use. Despite the risk factors observed for VT, none of the children were infected. Proper immunoprophylaxis is essential to prevent VT in children born to HBV-positive women.

The Prevalence of Rectovaginal Colonization and Antibiotic Susceptibility Pattern of Streptococcus agalactiae in Pregnant Women in Al-Zahra Hospital, Rasht, Iran

Background Maternal rectovaginal colonization with group B streptococcus (GBS) is a main risk factor for vertical transmission of GBS to newborns and life-threatening neonatal invasive diseases. The aim of this study was investigation of the prevalence of anorectal and vaginal colonization with GBS in late of pregnancy by culture-based and polymerase chain reaction (PCR) methods and antimicrobial susceptibility patterns of the GBS isolates in Rasht, Iran. Methods We analyzed 245 anorectal and vaginal swab samples separately from pregnant women at 35 to 37 weeks of gestation. All samples were cultured after enrichment in a selective Todd-Hewitt broth and then assayed by phenotypic characterizations and PCR method for cfb conserved gene. Antimicrobial susceptibility was performed using the Kirby–Bauer method. Results In total of 245 vaginal samples, 19 (7.8%) were positive based on culture method and 28 (11.4%) by PCR method. Among 245 rectal samples, 24 (9.8%) were positive by culture and 29 (11.8%) samples were positive by PCR. Of 245 pregnant women studied were found to have 9.7% GBS rectovaginal by culture and 15.9% by PCR methods. All GBS isolates were sensitive to ampicillin (77.2%) and vancomycin (72.2%) and were resistant to Penicillin (88.6%), ceftriaxone (75%), clindamycin (95.4%), azithromycin (86.3%), tetracycline (61.3%), erythromycin (47.7%), and levofloxacin (27.2%). Conclusions The results of this study indicate that the frequency of GBS isolation from rectal samples was higher than vaginal samples by both culture and PCR. Our study recommended intrapartum antibiotic prophylaxis against GBS infections based on ampicillin or vancomycin for GBS carriers in Rasht.

Maternal Leishmania infantum infection status has significant impact on leishmaniasis in offspring.

Visceral Leishmaniasis is a deadly disease caused by Leishmania infantum, endemic in more than 98 countries across the globe. Although the most common means of transmission is via a sand fly vector, there is growing evidence that vertical transmission may be critical for maintaining L. infantum infection within the reservoir, canine, population. Vertical transmission is also an important cause of infant morbidity and mortality particularly in sub-Saharan Africa. While vertical transmission of visceralizing species of Leishmania has been reported around the globe, risk factors associated with this unique means of Leishmania transmission have not been identified therefore interventions regarding this means of transmission have been virtually non-existent. Furthermore, the basic reproductive number, (R0), or number of new L. infantum infections that one infected mother or dam can cause has not been established for vertical transmission, also hampering the ability to assess the impact of this means of transmission within reservoir of human hosts. Canine Leishmaniosis (CanL) is enzootic within a U.S. hunting dog population. CanL is transmitted within this population via transplacental transmission with no reported vector transmission, despite many repeated attempts to find infected sand flies associated with these dogs and kennels. This population with predominantly, if not solely, vertical transmission of L. infantum was used to evaluate the critical risk factors for vertical transmission of Leishmania and establish the R0 of vertical L. infantum infection. Evaluation of 124 animals born to eighteen dams diagnostically positive for infection with L. infantum showed that there was a 13.84x greater chance of being positive for L. infantum within their lifetime if the mother was also positive within her lifetime (RR: 13.84, 95% CI: 3.54–54.20, p-value: <0.0001). The basic reproductive number for vertically transmitted L. infantum within this cohort was 4.12. These results underscore that there is a high risk of L. infantum infection to transmit from mother to offspring. Targeted public health interventions and control efforts that address vertical transmission of L. infantum are necessary in endemic countries to eliminate visceral leishmaniasis.

Editorial introductions

Editorial introductions

Врожденный токсоплазмоз при многоплодной беременности – факторы риска вертикальной трансмиссии

Врожденный токсоплазмоз при многоплодной беременности – факторы риска вертикальной трансмиссии

Vertical transmission of human papillomavirus in pregnancy: a systematic review and meta-analysis

Background: Human Papillomavirus (HPV) is the sexually transmitted infection and cause of cervical cancer, with considerable morbidity and mortality worldwide. Objective: We evaluated and summarized the available evidence on the vertical transmission rate of HPV in pregnant women for their newborns, as well as the possible risk factors for vertical transmission of HPV. Methods & Materials: This systematic review and meta-analysis was conducted using the PubMed and Web of Knowledge databases, with articles published between 2006 and 2016, according to PRISMA statement. Results: Of the 361 identified studies, thirteen were selected. All selected studies analyzed possible association of HPV transmission among pregnant women. The presence of HPV virus was detected in all mothers in all articles analyzed, and positivity in children was reported in eleven of the thirteen papers (84.6%). Among the analyzed articles, the prospective design prevailed and the variation of the positive sample varied between 13 and 169 women, all with ages ranging from 18 to 46 years. HPV virus type was classified in most studies, and the highest risk type was the most frequent. Conclusion: As a conclusion, the meta-analysis allowed to evaluate evidence of significant agreement of vertical transmission between pregnant and newborn women and between HPV virus transmission. The possibility of transmission of HPV from the mothers to the newborn has been reported in breast milk, umbilical cord and placenta, which increases the risk of contamination to the baby, emphasizing the need for increased care during pregnancy and birth.

Editorial introductions

Editorial introductions

An Overview of Risk Factors of Vertical Transmission of Hepatitis C Virus and Treatment Options for Chronic HCV

This essay focuses on hepatitis C transmission, the methods used for viral screening and the risk factors involved in mother-to-child transmission. Bearing in mind that HCV infected children rarely clear the infection after the age of four, different treatment options for chronic HCV will be discussed. Additionally, to identify the most effective treatment for children and adults, monotherapy will be compared to combined therapy.

Hepatitis c virus antibodies in mother-infant blood pair in Zaria

Objectives: To determine the prevalence of Hepatitis C virus (HCV) antibodies in mother-infant pair, and risk factors for vertical transmission of HCV in ABUTH Zaria.Method: One hundred motherinfant pair had serological determination for HCV antibodies from birth to 28days and a repeat at 6weeks after delivery. HIV antibody test and serum alanine transaminase level estimation were done for the mothers at the time of enrolment. Data including mothers’ demography, pregnancy and delivery history, relevant past medical history as well as physical examination of all babies were obtained and entered into a proforma designed by the researcher. Data was analyzed using SPSS version 15.0.Results: Prevalence of HCV antibodies was 5% and 6.8% in mothers and babies respectively at enrolment, while vertical transmission occurred in 60%. Five (5%) mothers had raised serum alanine transaminase. There was no new infection during the follow up period. There was no statistical significance between multiple sexual partners, history of prior blood transfusion, and or jaundice and maternal HCV infection.Conclusion: This study has been able to establish Mother to Child Transmission (MTCT) of HCV in our community (Zaria), This is of public health significance. The findings of this study further corroborate the need for more public enlightenment on routes of transmission and prevention of HCV infection .It is thus recommended to institute screening of antenatal care attendees and women of reproductive age.

РИЗИК ІНФІКУВАННЯ ПЛОДА І НОВОНАРОДЖЕНОГО У ВАГІТНИХ ЖІНОК З HBV- І HCV-ІНФЕКЦІЄЮ

Мета роботи – проаналізувати фактори ризику вертикальної трансмісії (ВТ) вірусів гепатитів В (ВГВ) і С (ВГС) від матері до дитини з метою профілактики внутрішньоутробного інфікування плода і новонародженого.Результати дослідження. Реплікативні форми НВV-інфекції діагностували у 32,4 % вагітних жінок, носійство ВГВ – у 67,6 %. У інфікованих НСV переважали реплікативні форми хвороби (61,0 %), а носійство встановили у 39,0 % пацієнток.У жінок з реплікативними формами НВV- та НСV-інфекції (4,4 і 2,8 % відповідно), високим ВН і мінімальним ступенем активності гепатиту спостерігали репродуктивні втрати – ранні та пізні викидні, завмерлу вагітність. У 8,7 % вагітних з реплікативними формами HBV-інфекції, високим ВН і мінімальним ступенем цитолізу, пологорозрішення яких проведено шляхом кесарського розтину, всі діти народилися неінфіковані. Висновки. Вертикальна передача ВГВ і ВГС відбувається при високому рівні ВН в ІІІ триместрі вагітності, особливо перед пологами, а також під час природного пологорозрішення таких жінок. Ступінь активності гепатиту не впливає на ризик перинатального інфікування.У жінок з реплікативними формами HВV- та HСV-інфекції мали місце репродуктивні втрати, ймовірно, пов’язані із підвищеною проникливістю плаценти до вірусів.

Risk factors for vertical transmission of hepatitis E virus infection.

Hepatitis E virus (HEV) infection can be vertically transmitted, but the factors that transmit the disease to foetuses are still unclear. We studied a total of 144 pregnant women with HEV infection. Cord blood and newborn samples were taken for analysis. Nutritional factors were evaluated on the basis of anthropometric parameters and biochemical factors, and HEV viral load was quantified by real-time PCR. Sequencing of HEV-positive samples was performed. Approximately 14.63% (6/41) of pregnant patients with acute liver failure (ALF) died before delivery. Vertical transmission was observed in 46.09% (59/128) of HEV-IgM-positive mothers. Approximately 23.80% (10/42) of newborns in the acute viral hepatitis group and 29.41% (5/17) in the ALF group were positive for HEV-RNA. No significant difference was observed in the occurrence of vertical transmission in HEV groups. Viral load was found to be a significant predictor for vertical transmission of HEV infection adjusted with haemoglobin and folate in derivation cohort group. Incorporating these variables, a new score predicting vertical transmission of HEV was derived. Using these significant predictors, the probability for vertical transmission of HEV was well stratified in the validation group (P>.05). In conclusion, viral load was associated with vertical transmission of HEV infection. A valid prediction score model was generated that was verified in a validation cohort group.

Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis.

Vertical transmission (VT) is the primary route of transmission of viral hepatitis in children. The rate of VT ranges from 1–28% with hepatitis B virus (HBV) and 3–15% with hepatitis C virus (HCV). VT for both viruses can occur during the intrauterine or peripartum period. VT of HBV primarily occurs by intrauterine transmission (IUT). Hepatitis B surface antigen is unable to cross the placenta and, therefore, relies on processes like transplacental leakage, placental infection, cellular transmission by peripheral blood mononuclear cells, and germline transmission. HCV can also infect the fetus by IUT. Both viruses also have the potential for transmission during delivery, when there is increase chance of maternal–fetal blood exposure. HBV and HCV share some common risk factors for VT, including maternal viral load, human immunodeficiency virus co-infection and neonatal sex. Prevention of VT differs greatly between HBV and HCV. There are several alternatives for prevention of HBV VT, including antiviral medications during the third trimester of pregnancy and HBV vaccine, as well as hepatitis B immunoglobulin administration to infants post-partum. In contrast, there are no preventative interventions available for HCV. Despite these differences, the key to prevention with both viruses is screening women prior to and during pregnancy.