Hepatitis C infection in children has a different course than in adults, with higher rates of spontaneous clearance. Prenatal (vertical) transmission is the most common route of transmission in childhood. Only a high maternal viral load and HIV co-infection have been proven to increase the risk of infection in the offspring. There is thus no evidence to recommend abstinence from breastfeeding, or elective C-section to prevent transmission. Standard interferon, pegylated interferon and ribavirin are the only approved therapies in children. Severe liver disease is extremely rare in childhood, and described mainly in patients contaminated through blood transfusion. (C) 2012 Elsevier Masson SAS. All rights reserved.