Risk Factors for Perinatal Transmission of Hepatitis C Virus

Authors

• Mona Prasad
• George R Saade
• Rebecca G Clifton
• Grecio J Sandoval
• Brenna L Hughes
• Uma M Reddy
• Anna Bartholomew
• Ashley Salazar
• Edward K Chien
• Alan T N Tita
• John M Thorp
• Torri D Metz
• Ronald J Wapner
• Vishakha Sabharwal
• Hyagriv N Simhan
• Geeta K Swamy
• Kent D Heyborne
• Baha M Sibai
• William A Grobman
• Yasser Y El-Sayed
• Brian M Casey
• Samuel Parry
• Mobeen Rathore
• Rodrigo Diaz-Velasco
• Ana M Puga
• Andrew Wiznia
• Andrea Kovacs
• David J Garry
• George A Macones
• for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network*

Language

English

Publication Date

9-1-2023

Journal

Obstetrics & Gynecology

DOI

10.1097/AOG.0000000000005306

PMID

37590978

PMCID

PMC10437102

PubMedCentral® Posted Date

9-1-2024

PubMedCentral® Full Text Version

Author MSS

Abstract

Objective: 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.

Methods: 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.

Conclusion: Perinatal transmission of HCV infection was limited to viremic individuals. High viral loads and antepartum bleeding were associated with perinatal transmission.

Keywords

Child, Female, Pregnancy, Humans, Hepacivirus, Prospective Studies, Hepatitis C, Risk Factors, RNA, Uterine Hemorrhage

Published Open-Access

yes

Recommended Citation

Prasad, Mona; Saade, George R; Clifton, Rebecca G; et al., "Risk Factors for Perinatal Transmission of Hepatitis C Virus" (2023). Faculty, Staff and Student Publications. 3900.
https://digitalcommons.library.tmc.edu/uthmed_docs/3900