Hepatitis C in Pregnancy: Screening and Current Treatments

Abstract

Hepatitis C virus (HCV) infection affects around 170 million men and women all over the world. Many patients with chronic HCV infection do not present with active symptoms until years after contracting the disease. In particular, women with quiescent HCV infection may become pregnant and deliver their child without knowing they were even infected. Thus, vertical transmission of HCV from mother to infant remains the single largest contributor to childhood HCV infection. Specific factors present before, during, or after pregnancy can increase the risk of HCV transmission from mother to infant. Some of these factors include a high viral load at the time of delivery, HIV co-infection, vaginal or perineal lacerations during delivery, and/or having a prolonged rupture of membranes. Despite these specific instances, the transmission rate from mother to infant still remains fairly low at around 1–8 %. New medications in the category of direct-acting antivirals may show promise in treating HCV in pregnant women. Many of these oral drug combinations such as sofosbuvir/ledipasvir, elbasvir/grazoprevir, and ombitasvir/paritaprevir/ritonavir/dasabuvir have been studied in pregnant animal populations but have limited to no results in human populations. The door remains open for future studies of these drugs to treat pregnant women during pregnancy that may help reduce viral loads and prevent vertical transmission of HCV infection to the infant.