VIDEO: Importance of HCV screening in pregnancy
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Healio spoke with Nancy S. Reau, MD, FAASLD, AGAF, about results from a study examining maternal and childhood outcomes of hepatitis C presented at The Liver Meeting Digital Experience.
The CDC, U.S. Preventive Services Task Force and other medical societies, including the American College of Gynecology and the Society for Maternal-Fetal Medicine, recommend HCV screening in every pregnancy, as they recognize that many new HCV infections occur in women of childbearing age, according to Reau, the Richard B. Capps Chair of Hepatology at Rush University in Chicago.
In the study, researchers used a large database of women from Ontario, Canada, to analyze pregnancy outcomes as well as maternal-to-childhood transmission in women who were HCV-positive and HCV-negative.
“The populations weren’t perfectly matched,” Reau said, noting that injection drug use and cirrhosis were more common in the HCV population. “We realize that those are going to contribute to outcome.”
Among patients with HCV, the risk for preterm birth and maternal complications was slightly higher, but the majority of pregnancies were well tolerated in this population. HCV screening, though, was less common than one would hope, with minority of infants screened, according to Reau.
The researchers also found that viral load was an important fact in the potential for maternal-to-childhood transmission. If viral load was low, then infants were highly unlikely to be infected, Reau noted.
Reau also said it was interesting that the testing strategy for infants was different. HCV PCR was used in a minority of infants, but most still had HCV antibody testing around the 18-month mark, which is what guidelines recommend.
“So, there was no treatment in this population during pregnancy, but it is nice to see that, for the most part, that maternal and childhood outcomes are good, with a slight signal in HCV-positive mothers,” Reau said. “[These data] kind of support that new screening strategy to identify mothers who are HCV-infected in that pregnancy, which offers an opportunity not necessarily to change pregnancy or decrease the rate of maternal-to-childhood transmission but to link them to curative therapy postpartum.”
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