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High viral load and bleeding before delivery may increase risk of perinatal transmission of hepatitis C
High viral load and bleeding before delivery may increase the risk of perinatal transmission of hepatitis C suggests a new study published in the Obstetrics & Gynecology.
A study was done to estimate the rate of perinatal transmission of hepatitis C virus (HCV) infection, to identify risk factors for perinatal transmission of HCV infection, and to determine the viremic threshold for perinatal transmission.
This was a prospective, multicenter, observational study of pregnant individuals at less than 24 weeks of gestation screened for HCV infection from 2012 to 2018 in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Individuals found to be HCV antibody–positive were followed throughout pregnancy. Children were followed for evidence of perinatal transmission at 2–6 months (HCV RNA testing) and at 18–24 months (HCV RNA and antibody testing) of life. The primary outcome was perinatal transmission, defined as positive test results at either follow-up time point.
RESULTS:
A total of 109,379 individuals were screened for HCV infection. Of the 1,224 participants who screened positive, 772 (63.1%) enrolled and 432 of those 772 (56.0%) had data available to assess primary outcome. The overall rate of perinatal transmission was 6.0% (26/432, 95% CI 4.0–8.7%). All children with HCV infection were born to individuals with demonstrable viremia. In viremic participants (n=314), the perinatal transmission rate was 8.0% (95% CI 5.2–11.5%). Risk factors for perinatal transmission included HCV RNA greater than 106 international units/mL (adjusted odds ratio [aOR] 8.22, 95% CI 3.16–21.4) and vaginal bleeding reported at any time before delivery (aOR 3.26, 95% CI 1.32–8.03). A viremic threshold for perinatal transmission could not be established.
Perinatal transmission of HCV infection was limited to viremic individuals. High viral loads and antepartum bleeding were associated with perinatal transmission.
Reference:
Prasad, Mona DO, MPH; Saade, George R. MD; Clifton, Rebecca G. PhD; Sandoval, Grecio J. PhD; Hughes, Brenna L. MD, MS; Reddy, Uma M. MD, MPH; Bartholomew, Anna MPH, BSN; Salazar, Ashley DNP; Chien, Edward K. MD; Tita, Alan T. N. MD, PhD; Thorp, John M. Jr MD; Metz, Torri D. MD, MS; Wapner, Ronald J. MD; Sabharwal, Vishakha MD; Simhan, Hyagriv N. MD; Swamy, Geeta K. MD; Heyborne, Kent D. MD; Sibai, Baha M. MD; Grobman, William A. MD, MBA; El-Sayed, Yasser Y. MD; Casey, Brian M. MD; Parry, Samuel MD; Rathore, Mobeen MD; Diaz-Velasco, Rodrigo MD; Puga, Ana M. MD; Wiznia, Andrew MD; Kovacs, Andrea MD; Garry, David J. MD; Macones, George A. MD, MSCE; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network*. Risk Factors for Perinatal Transmission of Hepatitis C Virus. Obstetrics & Gynecology 142(3):p 449-456, September 2023. | DOI: 10.1097/AOG.0000000000005306
Keywords:
High, viral, load, bleeding, before, delivery, increase, risk, perinatal, transmission, hepatitis C, Obstetrics & Gynecology
Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751