Treatment of Women With Hepatitis C Diagnosed in Pregnancy: a Co-Located Treatment Approach

Abstract

The development of direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) has revolutionized the management of HCV among virtually all patients. However, perhaps the last frontier of HCV treatment is in individuals with HCV during pregnancy for whom there are no specific guidelines for treatment. 1 Kushner T. et al. Ther Adv Infect Dis. 2019; 6: 1-4 Google Scholar Over the past decade, in relation to the increased rates of opioid use among young individuals, a significant increase has been seen in HCV seen among women of childbearing years and in women during pregnancy. 2 Rossi R.M. et al. Obstet Gynecol. 2020; 135: 387-395 Crossref PubMed Scopus (17) Google Scholar Over the past 2 years, the American Association for the Study of Liver Diseases, Centers for Disease Control and Prevention, US Preventative Services Task Force, and, most recently, the American College of Obstetricians and Gynecologists have each recommended screening of all women for HCV during pregnancy. For individuals who screen positive for HCV in pregnancy, per American Association for the Study of Liver Diseases guidelines, “treatment can be considered during pregnancy on an individual basis after a patient-physician discussion about the potential risks and benefits.” 3 American Association for the Study of Liver Diseases. https://www.hcvguidelines.org/unique-populations/pregnancy Google Scholar However, despite these recommendations and a published clinical trial of the use of sofosbuvir/ledipasvir in pregnancy 4 Chappell C.A. et al. Lancet Microbe. 2020; 1: e200-e208 Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar (and others currently underway), presently there are no published real-world data regarding HCV treatment during pregnancy in the United States. We describe a case series of women who screened positive for HCV during pregnancy and were referred to our practice for HCV treatment.