Women With Chronic Hepatitis C Virus Infection

Recommendations for Clinical Practice

Mary Jane Burton, MD; James B. Brock, MD; Stephen A. Geraci, MD


South Med J. 2013;106(7):422-426. 

In This Article

Abstract and Introduction


The natural history of hepatitis C virus infection differs between women and men. Women demonstrate a slow rate of disease progression until menopause. Older women are more likely to develop fibrosis and are less responsive than younger women to pegylated interferon and ribavirin. Women of childbearing age have higher rates of sustained virologic response, but current therapies are contraindicated during pregnancy. Vertical transmission of hepatitis C virus occurs, but data supporting recommendations for prevention of mother-to-infant transmission are limited.


Approximately 3 million people in the United States are chronically infected with the hepatitis C virus (HCV),[1] which is transmitted primarily through contact with the blood of an infected person. Acute infection resolves in approximately 20% of cases and the rest develop chronic infection.[2] The major sequelae of chronic HCV infection are cirrhosis and hepatocellular carcinoma.[2] The clinical course varies widely among individuals, with sex influencing the natural history and clinical outcomes. Understanding the unique features in women will assist clinicians in managing female patients with chronic HCV infection.