1034. IL28B is Predictive of Spontaneous Postpartum Clearance of Chronic Hepatitis C Virus Infection in Pregnant women
Session: Poster Abstract Session: Hepatitis Viruses
Friday, October 9, 2015
Room: Poster Hall
Posters
  • IDWeek_2015_Presentation no. 1034 [M. Hashem].pdf (99.8 kB)
  • Background: IL28B is a predictor of spontaneous clearance in acute hepatitis C virus (HCV), infection, but its role in spontaneous clearance of chronic HCV is unknown. This study aimed to identify predictors of spontaneous chronic HCV clearance in pregnant women with chronic HCV infection.

    Methods: This is a prospective cohort study done at Cairo University’s antenatal where pregnant women were enrolled and screened for anti-HCV positive antibodies. Those who were positive were tested for viremia with quantitative real-time PCR at baseline and every 3 months for 12 months after delivery. Viremic women were tested for IL28B polymorphism (rs12979860). Women with 2 undetectable viral loads at least 6 months apart including their last visit were considered to have spontaneous HCV clearance. Associations between demographic, obstetrical and HCV risk factors and clearance were assessed. Fisher's exact and Mann Whitney-U tests were used for analysis of categorical and continuous variables, respectively.

    Results: Of 2514 pregnant women, 98 had positive anti-HCV antibodies, of whom 54 were HCV viremic. To date, 50 of 54 women both completed their 1-year follow-up and were tested for IL28B. Their mean age was 31.6+5.3 years, with 28 (56%), 15 (30%) and 6 (12%) having CC, CT and TT polymorphisms, respectively. Of those, 36/50 (72%) had a significant (>0.5 log) drop in their HCV viral load within the first 3 months after delivery, 58% of whom had a CC genotype, and 7 had complete HCV clearance (14%) by their 12-month visit. Among those who cleared, 6 had CC genotype (86%), 1 had CT, and none had TT. Other than IL28B status, there were no other predictors for viral clearance. Age, baseline viral load, obstetrical history (delivery method, previous C-section, number of  pregnancies, abortions, premature, full-term and live births) and HCV risk factors (history of jaundice, liver disease, surgery, blood transfusion, needle-sticks, tattoos, injections, endoscopy, dialysis , dental work or healthcare sector employment ), were not associated with viral clearance (p>0.05). 

    Conclusion: IL28B-CC genotype was the best predictor for a significant drop in viral load in the immediate postpartum period, and for viral clearance in pregnant women with chronic HCV. HCV-infected pregnant women should be re-tested after delivery, particularly if they have an IL28B-CC genotype.

    Mohamed Hashem, MBBCh, MSc1, Samer El-Kamary, MBChB, MS, MPH2, Ravi Jhaveri, MD, FIDSA, FPIDS3, Doa'a Saleh, MBBCh, MSc, MD4, Mohamed Ehab, MBBCh, MSc, MD5, Sahar Sharaf, MBBCh, MSc, MD6, Fatma El-Mougy, MBBCh, MSc, MD6, Lobna Abdelsalam, MBBCh, MSc6, Ahmed Aboulnasr, MBBCh, MSc, MD5 and Hesham El-Ghazaly, MBBCh, MSc, MD7, (1)Epidemiology and Public Health, University of Maryland School of Medicine, Cairo, Egypt, (2)Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, (3)Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, (4)Public Health and Community Medicine, Cairo University, Cairo, Egypt, (5)Obstetrics and Gynaecology, Cairo University, Cairo, Egypt, (6)Clinical and Chemical Pathology, Cairo University, Cairo, Egypt, (7)Obstetrics and Gynecology, Cairo University, Cairo, Egypt

    Disclosures:

    M. Hashem, Merck: Investigator , Research support

    S. El-Kamary, Merck: Investigator , Research support

    R. Jhaveri, MedImmune: Grant Investigator , Research grant
    merck: Grant Investigator , Research grant
    Genentech: Scientific Advisor , Consulting fee

    D. Saleh, None

    M. Ehab, None

    S. Sharaf, None

    F. El-Mougy, None

    L. Abdelsalam, None

    A. Aboulnasr, None

    H. El-Ghazaly, Merck: Investigator , Research support

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