Acceptability of Hepatitis C screening and treatment during pregnancy in pregnant women in Egypt, Pakistan and Ukraine

The risk of vertical transmission of hepatitis C virus (HCV) is ≈6%, and there is growing evidence that maternal HCV adversely affects pregnancy and infant outcomes. However, antenatal HCV screening is not routinely provided in most settings, and direct acting antivirals (DAA) are not approved for pregnant/ breastfeeding women. We conducted a cross-sectional survey of pregnant/post-partum women in Egypt, Pakistan and Ukraine to assess the acceptability of universal antenatal HCV screening and DAA treatment in the scenario of DAAs being approved for use in pregnancy. Among 630 women (n=210 per country), 73% were pregnant and 27% postpartum, 27% ever HCV antibody or PCR positive. Overall, 93% of women supported HCV screening and 88% would take DAAs in pregnancy (92%, 98% and 73% in Egypt, Pakistan and Ukraine, respectively), mostly to prevent vertical transmission/adverse pregnancy outcomes. Clinical trials to evaluate the safety and efficacy of DAAs in pregnancy are urgently needed.