Maternal viral load and risk of vertical transmission in patients with Hepatitis C

Oliver, Emily A.; Waterman, E J; Kuncio, Danica; Addish, Eman; Fenkel, Jonathan M.; Tholey, Danielle; Schuster, Meike

doi:10.1016/j.ajog.2021.11.470

Cited by 1 publication

(1 citation statement)

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“…The HCV RNA titer has been shown to be strongly associated with HCV vertical transmission in several studies, and this is consistent with the results of this study [10][11][12]23,24]. The absolute lymphocyte count and platelet count have not previously been reported to be associated with HCV vertical transmission, but those risk factors were not commonly studied [23].…”

Section: Results In the Context Of What Is Knownsupporting

confidence: 91%

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

Wasuwanich,

So,

Presnell

et al. 2024

Pathogens

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Background: Prevention of the vertical transmission of the hepatitis C virus (HCV) presents an obstetric challenge. There are no approved antiviral medications for the treatment or prevention of HCV for pregnant patients. Objective: We aimed to create a composite score to accurately identify a population of pregnant patients with HCV who have high potential for vertical transmission. Study Design: In a retrospective, multicenter cohort study, we identified pregnant patients with hepatitis C with linked data to their infants who have had HCV RNA or HCV antibody testing. Demographic data, including age and race/ethnicity, as well as clinical and laboratory data, including tobacco/alcohol use, infections, liver function tests, the HCV RNA titer, HCV antibody, HCV genotype, absolute lymphocyte count, and platelet count, were collected. Data were analyzed using logistic regression and receiver operating characteristics (ROCs) and internally validated using the forward selection bootstrap method. Results: We identified 157 pregnant patients and 163 corresponding infants. The median maternal delivery age was 29 (IQR: 25–33) years, and the majority (141, or 89.8%) were White. A high HCV RNA titer, high absolute lymphocyte count, and high platelet count were associated with vertical transmission. A high HCV RNA titer had an AUROC of 0.815 with sensitivity, specificity, a positive predictive value, and a negative predictive value of 100.0%, 59.1%, 17.6%, and 100.0%, respectively. A composite score combining the three risk factors had an AUROC of 0.902 (95% CI = 0.840–0.964) but with a risk of overfitting. Conclusions: An HCV RNA titer alone or a composite score combining the risk factors for HCV vertical transmission can potentially identify a population of pregnant patients where the rate of vertical transmission is high, allowing for potential interventions during antepartum care.

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