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Risk Factors for Perinatal Transmission of Hepatitis C Virus

Mona Prasad1, George R Saade, Rebecca G Clifton

  • 1Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, University of Texas Medical Branch, Galveston, Texas, Brown University, Providence, Rhode Island, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio, University of Alabama at Birmingham, Birmingham, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, University of Utah Health Sciences Center, Salt Lake City, Utah, Columbia University, New York, New York, Boston Medical Center, Boston, Massachusetts, University of Pittsburgh, Pittsburgh, Pennsylvania, Duke University, Durham, North Carolina, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas, Northwestern University, Chicago, Illinois, Stanford University, Stanford, California, University of Texas Southwestern Medical Center, Dallas, Texas, University of Pennsylvania, Philadelphia, Pennsylvania, University of Florida Center for HIV/AIDS Research, Education and Service, Jacksonville, Florida, San Juan Hospital, San Juan, Puerto Rico, Children's Diagnostic and Treatment Center, Fort Lauderdale, Florida, Jacobi Medical Center, Bronx, New York, University of Southern California, Los Angeles, California, SUNY Stony Brook, Stony Brook, New York, and Washington University in St. Louis, St Louis, Missouri; and the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

Obstetrics and Gynecology
|August 17, 2023
PubMed

Insights

Hepatitis C virus (HCV) perinatal transmission occurred in 6.0% of cases, primarily in viremic individuals. High viral loads and antepartum bleeding significantly increased transmission risk.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Pediatrics

Background:

  • Hepatitis C virus (HCV) infection poses a risk for perinatal transmission from mother to child.
  • Understanding transmission dynamics and risk factors is crucial for prevention strategies.

Purpose of the Study:

  • To estimate the rate of perinatal hepatitis C virus transmission.
  • To identify key risk factors associated with mother-to-child HCV transmission.
  • To determine if a viremic threshold exists for perinatal HCV transmission.

Main Methods:

  • A prospective, multicenter observational study involved screening pregnant individuals for HCV infection.
  • HCV-positive participants were followed throughout pregnancy, and their infants were monitored for transmission.
  • Perinatal transmission was defined by positive HCV RNA or antibody tests in infants at follow-up.

Main Results:

  • The overall perinatal transmission rate of HCV was 6.0%.
  • Transmission was exclusively observed in viremic individuals, with a rate of 8.0% among them.
  • HCV RNA levels exceeding 106 IU/mL and antepartum vaginal bleeding were significant risk factors for transmission.

Conclusions:

  • Perinatal HCV transmission is limited to mothers with detectable viremia.
  • High maternal viral load and antepartum bleeding are significant risk factors for mother-to-child HCV transmission.
  • A definitive viremic threshold for perinatal transmission could not be established in this study.
Abstract

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