Antiviral Therapies Can Improve Fertility, Pregnancy Outcomes in HCV+ Women

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Many new cases of HCV are found in women of reproductive age.
Many new cases of HCV are found in women of reproductive age.

Results from a study examining hepatitis C (HCV) infection in women of childbearing age showed that successful treatment of the virus can positively impact fertility and reduce the pregnancy risks associated with the disease. These findings were published in the Journal of Hepatology.

Many new cases of HCV are found in women of reproductive age. Premature ovarian senescence among these women puts them at increased risk for infertility and for pregnancy-related health problems.

For the current study, researchers in Italy and the US examined 3 groups of women: (1) 100 HCV-positive women with chronic liver disease (CLD) age-matched with 50 women with hepatitis B virus (HBV) and CLD, and 100 healthy women; (2) 1998 HCV-positive women enrolled in PITER (Italian Platform for the Study of Viral Hepatitis Therapies); and (3) 6085 HCV mono-infected women compared with 20,415 HCV-negative women from a large US insurance database.

In the first cohort, compared with women infected with HBV, women infected with HCV had a higher risk for miscarriage (odds ratio [OR]: 6,905; 95% CI, 1.771-26.926), but successful antiviral treatment reduced the risk (OR: 0.255; 95% CI: 0.090-0.723). In the women enrolled in the PITER cohort, 42% of HCV+ women miscarried, and compared with women in the general population of the same age (15 to 49), they were less fertile (0.7 in HCV-positive women vs 1.37 in Italian population of the same age).

In the US cohort, compared with women who did not have HCV, HCV-positive women were significantly more likely to have infertility (OR: 2.439; 94% CI: 2.130-2.794), premature birth (OR: 1.34; 95% CI: 1.06-1.69), gestational diabetes (OR: 1.24; 95% CI: 1.02-1.51), and pre-eclampsia (OR: 1.206; 95% CI: 0.935-1.556), and significantly less likely to have a live birth (OR: 0.754; 95% CI: 0.622-0.913).

Based on the results of this study, early introduction of antiviral treatment has the potential to mitigate the fertility and pregnancy risks of women with HCV who are of childbearing age.

Reference

Karampatou A, Han X, Kondili L A, et al. Premature ovarian senescence and high miscarriage rate impair fertility in women with hepatitis C virus infection [published online September 4, 2017]. J Hepatol. doi:10.1016/j.jhep.2017.08.019

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