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Modeling-Based Response-Guided Hepatitis C Treatment During Pregnancy and Postpartum
Tatyana Kushner1, Custon T Nyabanga2, Scott J Cotler3
1Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Open Forum Infectious Diseases
|February 13, 2023
Summary
Treating hepatitis C virus (HCV) during pregnancy may reduce vertical transmission. Response-guided therapy with sofosbuvir/velpatasvir could shorten treatment duration, as shown in one case study.
Area of Science:
- Hepatology
- Virology
- Maternal-Fetal Medicine
Background:
- Hepatitis C virus (HCV) infection in pregnant individuals presents challenges for prenatal care.
- Treating HCV during pregnancy could decrease the risk of mother-to-child transmission.
- Individualized treatment durations may optimize patient outcomes.
Purpose of the Study:
- To explore the feasibility of response-guided therapy for HCV during pregnancy.
- To assess the efficacy of sofosbuvir/velpatasvir in a pregnant individual.
- To determine if treatment duration could be shortened using mathematical modeling.
Main Methods:
- A case study of a 27-year-old pregnant woman with HCV.
- Administration of sofosbuvir/velpatasvir therapy.
- Monitoring of HCV viral load at multiple time points.
- Mathematical modeling to predict treatment duration for cure.
Main Results:
- HCV viral load decreased biphasically during treatment.
- HCV was not detected at delivery, 16 days after therapy initiation.
- Mathematical modeling predicted a 7-week treatment duration for cure, a 5-week reduction from standard duration.
Conclusions:
- Response-guided therapy with sofosbuvir/velpatasvir is a potential strategy for treating HCV in pregnancy.
- This approach may allow for individualized and shorter treatment durations.
- Further research is needed to validate these findings in larger cohorts.
