No OB Hep C RX: Time For Change

Major health organizations, including the CDC and ACOG, recommend universal Hepatitis C Virus (HCV) screening for all pregnant women during each pregnancy and at time of delivery. Ideally, pregnant women should be screened for hepatitis C virus infection at the first prenatal visit of each pregnancy. If the antibody screen result is positive, hepatitis C virus RNA polymerase chain reaction testing is done to confirm the diagnosis. The risk of perinatal transmission of HCV is up to 9%, with at least one-third of transmissions occurring antenatally. While antiviral therapy is recommended for Hepatitis B in pregnancy with a viral load greater than 200,000 international units/mL to decrease the risk of vertical transmission, the same is not the case for Hep C. According to the ACOG CPG #6 from September 2023, there are no standard treatment protocols for Hep C in pregnancy but a new publication from the PINK journal (7 Dec 2025) is calling for a change. That new publication is, “Hepatitis C Treatment During Pregnancy: Time for a Practice Change”. Listen in for details.

1. ACOG CPG #6; Sept 2026

2. Bhattacharya D, Aronsohn A, Price J, Lo Re V. Hepatitis C Guidance 2023 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 2023;:ciad319. doi:10.1093/cid/ciad319.

3. Chappell CA, Kiser JJ, Brooks KM, et al. Sofosbuvir/¬Velpatasvir Pharmacokinetics, Safety, and Efficacy in Pregnant People With Hepatitis C Virus. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 2025;80(4):744-751. doi:10.1093/cid/ciae595.

4. Reau N, Munoz SJ, Schiano T. Liver Disease During Pregnancy. The American Journal of Gastroenterology. 2022;117(10S):44-52. doi:10.14309/ajg.0000000000001960.

5. Dutra, Karley et al. Hepatitis C Treatment During Pregnancy: Time for a Practice Change. American Journal of Obstetrics & Gynecology MFM, Volume 0, Issue 0, 101865

6. Society for Maternal-Fetal Medicine Consult Series #56: Hepatitis C in Pregnancy-Updated Guidelines: Replaces Consult Number 43, November 2017. Society for Maternal-Fetal Medicine (SMFM). Electronic address: pubs@smfm.org, Dotters-Katz SK, Kuller JA, Hughes BL. American Journal of Obstetrics and Gynecology. 2021;225(3):B8-B18. doi:10.1016/j.ajog.2021.06.008