{"id":22981,"date":"2025-12-09T13:17:40","date_gmt":"2025-12-09T18:17:40","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=22981"},"modified":"2025-12-10T13:22:47","modified_gmt":"2025-12-10T18:22:47","slug":"gaps-in-the-hepatitis-c-prenatal-and-postpartum-care-cascade","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/gaps-in-the-hepatitis-c-prenatal-and-postpartum-care-cascade\/","title":{"rendered":"Gaps in the hepatitis C prenatal and postpartum care cascade: rationale for treatment in pregnancy"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 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.<\/p>\n<p><strong>Methods<\/strong> \u2014 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.<\/p>\n<p><strong>Results<\/strong> \u2014 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.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Despite diagnosis, &lt;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.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 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 \u2014 [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[39,26,35],"migration-helper-qa-sample-set":[],"class_list":["post-22981","journal_article","type-journal_article","status-publish","hentry","topic-infectious-diseases","topic-maternity-and-neonatal-care","topic-public-health"],"acf":{"citation":"Mendlowitz AB, Flemming JA, Kushner T, Wong WWL, Greenwald ZR, Li W, Chen B, Kwong JC, Masterman C, Capraru C, Feld JJ, Biondi MJ. <em>Clin Infect Dis<\/em>. 2025; Dec 9 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1093\/cid\/ciaf578","ices_scientist":[21592,1228,1120,1149],"site":[6736],"research_program":[6741],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Gaps in the hepatitis C prenatal and postpartum care cascade: rationale for treatment in pregnancy<\/title>\n<meta name=\"description\" content=\"Background \u2014 Hepatitis C virus (HCV) infections have increased among younger populations, including pregnant people. While universal screening guidelines\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/gaps-in-the-hepatitis-c-prenatal-and-postpartum-care-cascade\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Gaps in the hepatitis C prenatal and postpartum care cascade: rationale for treatment in pregnancy\" \/>\n<meta property=\"og:description\" content=\"Background \u2014 Hepatitis C virus (HCV) infections have increased among younger populations, including pregnant people. While universal screening guidelines\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/gaps-in-the-hepatitis-c-prenatal-and-postpartum-care-cascade\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2025-12-10T18:22:47+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/gaps-in-the-hepatitis-c-prenatal-and-postpartum-care-cascade\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/gaps-in-the-hepatitis-c-prenatal-and-postpartum-care-cascade\\\/\",\"name\":\"ICES | Gaps in the hepatitis C prenatal and postpartum care cascade: rationale for treatment in pregnancy\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2025-12-09T18:17:40+00:00\",\"dateModified\":\"2025-12-10T18:22:47+00:00\",\"description\":\"Background \u2014 Hepatitis C virus (HCV) infections have increased among younger populations, including pregnant people. 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