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Войти в исследования Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
Gaps in the Hepatitis C Prenatal and Postpartum Care Cascade: Rationale for Treatment in Pregnancy.
СтатьяПоддержка исследования: вне правительства СШАПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mendlowitz Andrew B, Flemming Jennifer A, Kushner Tatyana, Wong William W L, Greenwald Zoë R, Li Wenbin, Chen Bo, Kwong Jeffrey C, Masterman Chelsea, Capraru Camelia, Feld Jordan J, Biondi Mia J
Аннотация
BACKGROUND: Hepatitis C virus (HCV) infections have increased among younger populations, including pregnant people. While universal screening guidelines have improved case-finding, studies suggest low postpartum linkage-to-care rates. Better understanding of the peripartum HCV care cascade at the population level is needed to inform optimal management, including the role of treatment in pregnancy.
METHODS: A retrospective cohort study linking pregnant individuals with HCV test records to health administrative data in Ontario, Canada. We examined the HCV care continuum, including during subsequent pregnancies. We used Andersen-Gill models to examine predictors of missed opportunities for treatment, defined as pregnancies occurring before/in absence of treatment, and initiating treatment.
RESULTS: From 2003 to 2021, we identified 42 797 pregnancies in 16 888 people who tested HCV antibody-positive between 1999 and 2021. Of antibody-positive individuals, 14 538 (86.1%) had RNA testing and 7457 (51.3%) tested RNA-positive. Treatment uptake was 1.1%, 2.5%, and 5.2% at 1, 2, and 5 years after RNA positivity. Ultimately, 3861 (51.8%) initiated treatment and 2277 (30.5%) demonstrated sustained virologic response. Among those with confirmed chronic HCV, 47.5% (n = 3025) experienced a missed opportunity for treatment, with 19.2% (n = 1221) having multiple missed opportunities. Numbers of pregnancies and diagnosis year pre-2012 were associated with higher likelihood of a missed opportunity for treatment, while diagnoses of substance use disorder, HIV, and chronic disease were associated with lower likelihood.
CONCLUSIONS: Despite diagnosis, <10% initiated treatment within 5 years of RNA positivity and multiple pregnancies occurred before treatment, resulting in repeated exposures. Additional efforts will be required to ensure linkage-to-care and treatment either during pregnancy or postpartum.
METHODS: A retrospective cohort study linking pregnant individuals with HCV test records to health administrative data in Ontario, Canada. We examined the HCV care continuum, including during subsequent pregnancies. We used Andersen-Gill models to examine predictors of missed opportunities for treatment, defined as pregnancies occurring before/in absence of treatment, and initiating treatment.
RESULTS: From 2003 to 2021, we identified 42 797 pregnancies in 16 888 people who tested HCV antibody-positive between 1999 and 2021. Of antibody-positive individuals, 14 538 (86.1%) had RNA testing and 7457 (51.3%) tested RNA-positive. Treatment uptake was 1.1%, 2.5%, and 5.2% at 1, 2, and 5 years after RNA positivity. Ultimately, 3861 (51.8%) initiated treatment and 2277 (30.5%) demonstrated sustained virologic response. Among those with confirmed chronic HCV, 47.5% (n = 3025) experienced a missed opportunity for treatment, with 19.2% (n = 1221) having multiple missed opportunities. Numbers of pregnancies and diagnosis year pre-2012 were associated with higher likelihood of a missed opportunity for treatment, while diagnoses of substance use disorder, HIV, and chronic disease were associated with lower likelihood.
CONCLUSIONS: Despite diagnosis, <10% initiated treatment within 5 years of RNA positivity and multiple pregnancies occurred before treatment, resulting in repeated exposures. Additional efforts will be required to ensure linkage-to-care and treatment either during pregnancy or postpartum.