A Composite Score for Predicting Vertical Transmission of Hepatitis C: A Multicenter Study

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Hepatology

Background:

• Vertical transmission of hepatitis C virus (HCV) poses a significant obstetric challenge.
• Currently, no antiviral medications are approved for treating or preventing HCV in pregnant individuals.

Purpose of the Study:

• To develop a composite score for accurately identifying pregnant patients with HCV at high risk for vertical transmission.
• To aid in targeted interventions during antepartum care.

Main Methods:

• Retrospective, multicenter cohort study involving pregnant patients with HCV and their infants.
• Collected demographic and clinical data, including HCV RNA titer, lymphocyte count, and platelet count.
• Utilized logistic regression and ROC analysis for data analysis and internal validation.

Main Results:

• Identified 157 pregnant patients and 163 infants.
• High HCV RNA titer, elevated absolute lymphocyte count, and high platelet count were associated with vertical transmission.
• A composite score demonstrated strong predictive performance (AUROC = 0.902), though with a risk of overfitting.

Conclusions:

• An HCV RNA titer alone or a composite score can identify pregnant patients with a high likelihood of vertical HCV transmission.
• These tools may facilitate the implementation of antepartum interventions to prevent mother-to-child transmission.