[Current status of genotyping of pregnant women with hepatitis C and its impact on pregnancy outcomes].

Abstract

Objective: To understand the current genotype distribution, epidemiological characteristics, and their relationship with pregnancy outcomes in pregnant women with hepatitis C in Nanjing city. Methods: An epidemiological survey method was used to analyze the data of 113 pregnant women with hepatitis C who were successfully genotyped and admitted to Nanjing Second Hospital from January 2018 to December 2023. The comparison of the quantitative data was analyzed by a t-test or rank-sum test between the two groups. The comparison of the enumeration data was analyzed using the χ² test, adjusted χ² test, or Fisher's exact probability method between the two groups. Results: A total of six kinds of genotypes (1b, 2a, 3a, 3b, 6a, 6n) were identified in 113 cases. The primary genotype was 1b (accounted for 76.1%), followed by 6, 3, and 2 rare genotypes, while 1 mixed type (type 2 mixed with type 6) and genotypes 4 and 5 were non-identified. The proportion of genotype 1b increased with the extension of the birth cohort, and the difference was statistically significant (χ²=24.35, P＜0.001). There was a difference in genotyping proportions with educational and employment background (χ²=14.74, P＜0.001; χ²=19.50, P＜0.001). The proportion of non-1b types increased in populations with low educational backgrounds and unemployment. The proportion of type 1b was higher in those with a history of blood transfusion and hospitalization during infancy (χ²=5.57, P=0.018; χ²=5.17, P=0.023). The proportion of non-1b type was higher in those with a history of drug abuse (χ²=22.32, P＜0.001). Normal pregnancy outcomes had no statistically significant difference between genotype 1b and non-1b groups. However, all pregnant women who experienced adverse infant outcomes had genotype 1b. Conclusion: Pregnant women with hepatitis C in Nanjing city are mainly genotype 1b, with genotype 3b<5%, and there is no significant difference in maternal and infant outcomes among different genotype subtypes. Therefore, no testing of genotype for women of childbearing age. However, the focus should be on the management of pregnancy, health education, and postpartum preparation for direct acting antiviral treatment.