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Risk Factors for Perinatal Transmission of Hepatitis C Virus. | LitMetric

Risk Factors for Perinatal Transmission of Hepatitis C Virus.

Obstet Gynecol

Departments 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.

Published: September 2023

AI Article Synopsis

  • The study aimed to estimate the rate of perinatal transmission of hepatitis C virus (HCV) and identify associated risk factors among pregnant individuals.
  • Conducted from 2012 to 2018, the research included screening for HCV in over 109,000 participants, with the main outcome measured being evidence of transmission in infants up to 2 years old.
  • Results showed a 6.0% perinatal transmission rate, predominantly in viremic individuals, with higher viral loads and antepartum bleeding identified as significant risk factors.

Article 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437102PMC
http://dx.doi.org/10.1097/AOG.0000000000005306DOI Listing

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