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Hepatitis C Virus Infection in Pregnancy and Children: Its Implications and Treatment Considerations with Directly

Ramesh Rana1, Rajkumar Dangal2, Yogendra Singh3

  • 1Department of Medicine, Ungoofaaru Regional Hospital, Ungoofaaru, RAA Atoll, Maldives.

JNMA; Journal of the Nepal Medical Association
|February 24, 2022
PubMed

Insights

Hepatitis C virus (HCV) infection affects millions globally. This review explores the safety and efficacy of directly acting anti-virals (DAAs) during pregnancy to prevent vertical transmission and aid HCV elimination.

Area of Science:

  • Hepatology
  • Virology
  • Public Health

Background:

  • Hepatitis C virus (HCV) infection is a significant global health issue, impacting over 71 million individuals worldwide.
  • High-risk populations, including pregnant women (8% of cases), require effective screening and treatment strategies.
  • Chronic HCV infection increases the risk of liver cirrhosis and hepatocellular carcinoma.

Purpose of the Study:

  • To review the potential use and safety of directly acting anti-virals (DAAs) for Hepatitis C virus (HCV) treatment during pregnancy.
  • To explore the feasibility of using pan-genotypic DAAs in late second and early third trimesters.
  • To support the World Health Organization's 2030 target for HCV elimination.

Main Methods:

  • Literature review focusing on DAAs' efficacy and safety in pregnant populations.
  • Analysis of pharmacokinetic data and potential fetal outcomes associated with DAAs.
  • Exploration of pan-genotypic regimens for late-stage pregnancy treatment.

Main Results:

  • Directly acting anti-virals (DAAs) demonstrate a cure rate of over 95% for chronic Hepatitis C virus (HCV) infection.
  • Current recommendations lack specific DAAs regimens for pregnancy due to insufficient evidence on fetal safety and pharmacokinetic effects.
  • Potential for using certain pan-genotypic regimens in late pregnancy warrants further investigation.

Conclusions:

  • Treating chronic Hepatitis C virus (HCV) infection, including pre-conception, can significantly reduce disease burden and vertical transmission.
  • Further research is crucial to establish safe and effective DAAs regimens for use during pregnancy.
  • Successful implementation of treatment strategies in pregnant women is vital for achieving the WHO's 2030 HCV elimination goals.

Keywords:
antiviral agents; hepatitis C virus; interferon-alpha; pregnancy; review; transmission; treatment.

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