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Hep B and Hep C
Hepatitis B (jaundice) and hepatitis C are viral diseases that infect the liver.
The main difference between the two is that there is no vaccine against hepatitis C. To minimise the risk of infection during sexual contact with your partner, we recommend you use condoms.
Transmission of hepatitis B and C is also possible through infected oocytes, sperm, and embryos. Additional precautions need to be taken to ensure you conceive a healthy baby.
If you are hepatitis B positive, your partner can get vaccinated. Hepatitis B can be prevented with an effective vaccine. We only consider starting an ART pathway if the partner has been vaccinated and has developed sufficient antibodies. If you have symptoms of hepatitis, you may require treatment before your fertility pathway.
Hepatitis B or C in men has no impact on your pregnancy and the birth of your baby. Fertilisation is done in vitro with ICSI, during which the highest-quality sperm cell is injected into the oocyte. The sperm is always thoroughly examined before fertilisation.
In most cases, hepatitis B or C infection in women has no impact on your pregnancy. You may, however, need hepatitis treatment before getting pregnant. Vaginal delivery and a caesarean section are both possible. During birth, the baby may be exposed to the virus and become infected as a result. To protect your baby, we will give him or her an injection of hepatitis B antibodies and a vaccination a few hours after birth. Please note the latter is not possible in the case of hepatitis C as there currently is no vaccine for this disease, meaning your baby cannot be vaccinated. We will, however, check your baby for the presence of the virus six months after birth.
HIV is a virus that attacks the immune system and can cause AIDS. Once you have been infected, the virus never leaves your body. Although the infection can be suppressed with drugs these days, a definitive cure is still not available.
Infection with the virus occurs through contact with body fluids containing the virus. Transmission can happen through sexual contact but also through needle stick or splash injuries, or also while breastfeeding. Infection through blood transfusion is non-existent in the western world because blood donors are rigorously screened. Transmission does not occur during day-to-day contacts such as shaking hands, hugging…
HIV increases the risk of foetal death, miscarriage, and preterm birth. That said, natural conception can take place safely in couples where one partner (or even both partners) is HIV-positive. Some strict conditions apply, however:
- you must use antiviral drugs correctly
- there is sufficient suppression of the virus in your blood (not detectable)
- you don’t have any other sexual transmissible infections; and
- you have no sexual contacts other than with your regular partner.
If, as a woman, you are infected with HIV, the chance of your baby becoming infected during pregnancy is minimal because of the antiviral drugs you take. This ensures that the HIV virus load in the body is as low as possible. It also minimises the risk of transmission to your baby.
The risk of transmission to your baby is highest during birth. When the membranes break, the baby comes into contact with its mother’s bodily fluids. Vaginal delivery is always first option, as the medication should suppress the viral load of the HIV virus. If HIV virus is detectable at the time of delivery, however, we may opt for a caesarean.
To find out whether your baby is infected or not after birth, a number of preventive blood tests are scheduled: at birth, at three weeks, after two to three months, after six months, at 1 year, and at 1.5 years.
Your baby will also be given medication in the form of a syrup after birth.
ART treatment with fertilisation in the lab through ICSI is the recommended pathway for HIV positive men. This involves a rigorous selection of sperm cells and injecting a single sperm cell into the oocyte. The lab will select an HIV-negative sperm cell. As a result, HIV infection in men has no impact on pregnancy, birth, and the postpartum period.
. This involves a rigorous selection of sperm cells and injecting a single sperm cell into the oocyte. The lab will select an HIV-negative sperm cell. As a result, HIV infection in men has no impact on pregnancy, birth and the postpartum period.
Syphilis is a sexually transmitted infection (STI) for which there is no vaccine available. If the blood test prior to your ART treatment establishes that you are infected with syphilis, you can be treated with antibiotics.
There is a 60 per cent chance of the bacteria crossing the placenta during pregnancy and actively infecting the foetus, resulting in the foetus being at increased risk of abnormalities.
Arboviruses including ZIKA
Arboviruses are viral infections transmitted by arthropods. The main carriers are insects such as mosquitoes, ticks, and sandflies.
Major pathogens that are transmitted by these carriers include dengue, chikungunya virus, tick-borne encephalitis, West Nile virus, Crimean Congo virus, Zika virus, yellow fever, and the Japanese encephalitis virus.
Zika virus is mainly transmitted by Aedes mosquitoes which bite during the day. Infection during pregnancy can result in miscarriage or serious birth defects. Check out the risk areas for Zika virus at the link below if you want to go abroad while pregnant or intending to become pregnant.
If you have travelled to a high-risk area, the start of your treatment may be delayed for up to 3 months after your return to ensure that you did not become infected.
Five common questions about infectious diseases and pregnancy answered
When should I disclose that I have an infectious disease if we want to have children?
Dr. Liese Boudry
An STI does not prevent you from having children