HCV vertical transmission in pregnancy: New horizons in the era of DAAs

Kanninen, Tomi T.; Dieterich, Douglas T.; Asciutti, Stefania

doi:10.1002/hep.28032

Cited by 52 publications

(58 citation statements)

References 7 publications

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“…Currently, universal screening for HCV is not performed routinely in pregnant women and is reserved for those who are known to engage in “at‐risk” activities; this is highly likely to miss a significant number of infected children 24, 25. However, studies have shown that large‐scale antenatal screening programs can be feasible, effective, and affordable 26…”

Section: Epidemiologymentioning

confidence: 99%

Hepatitis C virus infection in children and adolescents

Squires

Balistreri

2017

Hepatology Communications

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Section: Epidemiologymentioning

confidence: 99%

Hepatitis C virus infection in children and adolescents

Squires

Balistreri

2017

Hepatology Communications

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“…The prevalence of HCV infection is between 0.5%-2% in most European countries and in the United States, in which 5-10 million and almost 4 million people, respectively, are affected, most of whom are in the fourth decade of life [1,[3][4][5] . Differently, the prevalence of HCV infection exceeds 10% in some developing countries (especially in Africa, Asia and South America) [1] .…”

Section: Introductionmentioning

confidence: 99%

“…One of the modes of HCV transmission is vertical transmission. Rates of vertical transmission of HCV infection range between 2%-10% [4] . Although HCV infection acquired at birth may resolve spontaneously, about 25000 to 50000 of children become chronically infected [4][5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

“…Rates of vertical transmission of HCV infection range between 2%-10% [4] . Although HCV infection acquired at birth may resolve spontaneously, about 25000 to 50000 of children become chronically infected [4][5][6][7] . The prevalence of HCV infection in children is very low in Europe and the United States (0.05%-0.36%) [8] , and increases to between 1.8% and 5.8% in Egypt (which has the highest prevalence of pediatric HCV infection), Sub-Saharan Africa, Mongolia and the Amazon Basin [8] .…”

Section: Introductionmentioning

confidence: 99%

“…The effect of maternal viremia on vertical transmission and on the rate of spontaneous resolution of the acquired infection among newborns is not well defined. However, mothers with undetectable plasma HCV RNA levels rarely transmit HCV by the vertical route [4] . Therefore, it seems reasonable to assume that treatment to decrease viremia in pregnant women with chronic HCV may result in lower rates of vertical HCV transmission.…”

Section: Introductionmentioning

confidence: 99%

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Antiviral therapy for hepatitis C: Has anything changed for pregnant/lactating women?

Spera

Eldin

Tosone

et al. 2016

WJH

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population, with the highest prevalence in individuals under 40. The prevalence in pregnant women varies with geographical distribution (highest in developing countries). Prevalence also increases in sub-populations of women at high risk for blood-transmitted infections. HCV infection in pregnancy represents a non-negligible problem. However, most of the past antiviral regimens cannot be routinely offered to pregnant or breastfeeding women because of their side effects. We briefly reviewed the issue of treatment of HCV infection in pregnant/breastfeeding women focusing on the effects of the new direct-acting antivirals on fertility, pregnancy and lactation in animal studies and on the potential risk for humans based on the pharmacokinetic properties of each drug. Currently, all new therapy regimens are contraindicated in this setting because of lack of sufficient safety information and adequate measures of contraception are still routinely recommended for female patients of childbearing potential. Core tip: Until recently, the only drugs available for the treatment of hepatitis C virus infection had a welldocumented teratogenic effect limiting their use in childbearing women. Recently, new generation drugs, designated the direct-acting antivirals have been approved. There are no studies available describing their effects on pregnant and lactating women. We here will try to analyze their pharmacokinetic properties and data from animal studies to try to predict their potential use pregnancy.Spera AM, Kamal Eldin T, Tosone G, Orlando R. Antiviral therapy for hepatitis C: Has anything changed for pregnant/ Anna Maria Spera, Tarek Kamal Eldin, Grazia Tosone, Raffaele Orlando Anna Maria Spera, Tarek Kamal Eldin, Grazia Tosone, Raffaele Orlando, Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Napoli, ItalyAuthor contributions: Spera AM designed and wrote the review; Kamal Eldin T analyzed pharmacological and clinical data; Tosone G and Orlando R overview the manuscript.Conflict-of-interest statement: All authors declare any conflicting interests (including but not limited to commercial, personal, political, intellectual or religious interests). In addition, reviewers have not potential conflicting interests related to any particular paper they maybe are asked to review.

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Evaluating Women’s Preferences for Hepatitis C Treatment During Pregnancy

Kushner

Cohen²,

Tien

et al. 2018

Hepatology Communications

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There is a rising prevalence of hepatitis C (HCV) among women of child‐bearing age nationally, which prompted a recommendation by national guidelines to screen all women for HCV during pregnancy. Women with HCV during pregnancy are at risk of perinatal transmission of HCV. Directly acting antiviral (DAA) therapy during pregnancy can potentially reduce the risk of perinatal transmission as well as cure women while they are engaged in antenatal care. However, data on the safety and efficacy of DAAs during pregnancy are limited. We aimed to evaluate the preferences of women with HCV regarding potential DAA treatment during pregnancy. We conducted a survey of women with a history of HCV followed in the University of California, San Francisco HCV clinic and in the Women’s Interagency HIV Study (most of whom are coinfected with HIV) to determine their preferences for DAA treatment during pregnancy. A total of 141 women completed the survey. Sixty percent reported that they would be willing to take antepartum DAA therapy if it lowered the risk of perinatal transmission. Only 21% reported that they would agree to take DAA therapy during pregnancy for self‐cure; 20% of women stated that they would not, yet indicated that they might change their minds if there were more human data available regarding use of DAAs during pregnancy. In multivariable analysis, having a previous history of taking DAAs and being of childbearing age at the time of the survey were associated with willingness to take DAA medication during pregnancy (odds ratios 4.29 and 4.11, respectively). Conclusion: These results point to the need for further investigation of the role of HCV therapy during pregnancy.

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HCV vertical transmission in pregnancy: New horizons in the era of DAAs

Cited by 52 publications

References 7 publications

Hepatitis C virus infection in children and adolescents

Hepatitis C virus infection in children and adolescents

Antiviral therapy for hepatitis C: Has anything changed for pregnant/lactating women?

Evaluating Women’s Preferences for Hepatitis C Treatment During Pregnancy

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