EXPERIENCE IN THE TREATMENT OF HEPATITIS C IN PREGNANT PATIENTS AT THE HEPATITIS CLINIC OF THE VERACRUZ HIGH SPECIALTY HOSPITAL

Introduction and Objectives

Currently, HCV treatment options during pregnancy are not well-defined. Typical clinical practice is to refer and link pregnant women for treatment after pregnancy and breastfeeding; however, in practice, very few have completed successful treatment. To date, three case series have been published that include safety results for HCV treatment in pregnancy. ACOG recommends that DAAs be initiated only through a clinical trial and that pregnant women while taking a DAA should be counseled about the risks and benefits of continuing treatment.

To report the experience of the HAEV Hepatitis Clinic with the treatment of 3 pregnant women with HCV on DAAs during the second half of pregnancy with sustained viral response (SVR) and no adverse effects to the combination to date.

Patients and Methods

Since 2021, three cases of pregnant women with HCV infection confirmed by viral load have been presented. After evaluation and categorization as F0-F1 by FIB 4, they were treated with Sofosbuvir-Velpatasvir 400/100 mg for 90 days

Results

Patients were treated with Sofosbuvir-Velpatasvir 400/100 mg for 90 days, with no reports of perinatal abnormalities. The subsequent negative viral load was achieved in the pair. Only one patient reported headache and dizziness as adverse symptoms. After monitoring, a planned termination of pregnancy was decided to reduce the risk of vertical transmission, and counseling on proper breastfeeding techniques was provided to discontinue breastfeeding.

Conclusions

Sofosbuvir-Velpatasvir was administered for 12 weeks without adverse effects on the pair, and SVR was achieved at the time of treatment in the three treated patients, demonstrating the effectiveness and safety of the treatment. This provides a solution to a public health and maternal-fetal problem in our setting, which prevents perinatal transmission. Following these results, we propose evaluating its use in similar cases with the intention of contributing to the eradication of HCV infection.