Modeling-Based Response-Guided Hepatitis C Treatment During Pregnancy and Postpartum

Tatyana Kushner; Custon T Nyabanga; Scott J Cotler; Ohad Etzion; Harel Dahari

doi:10.1093/ofid/ofad027

Modeling-Based Response-Guided Hepatitis C Treatment During Pregnancy and Postpartum

Open Forum Infect Dis. 2023 Jan 20;10(2):ofad027. doi: 10.1093/ofid/ofad027. eCollection 2023 Feb.

Authors

Tatyana Kushner¹, Custon T Nyabanga², Scott J Cotler³, Ohad Etzion⁴, Harel Dahari³

Affiliations

¹ Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
² Department of Gastroenterology, Mount Sinai Beth Israel, New York, New York, USA.
³ The Program for Experimental & Theoretical Modeling, Division of Hepatology, Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois, USA.
⁴ Department of Gastroenterology and Liver Diseases, Soroka University Medical Center, Beer-Sheva, Israel.

Abstract

Treating hepatitis C virus (HCV) in pregnancy would address HCV during prenatal care and potentially reduce the risk of vertical transmission. Response-guided therapy could provide a means to individualize and the reduce duration of HCV treatment during pregnancy. Data from a 27-year-old woman indicated that, pretreatment, HCV was stable and that it dropped in a biphasic manner during sofosbuvir/velpatasvir therapy, reaching target not detected at time of delivery-16 days post-initiation of therapy. Mathematical modeling of measured HCV at days 0, 7, and 14 predicted that cure could have been achieved after 7 weeks of sofosbuvir/velpatasvir, reducing the duration of therapy by 5 weeks.

Keywords: antiviral therapy; hepatitis C virus; pregnancy; response-guided treatment.

Abstract

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