Hepatitis C infection can be dangerous for mothers and babies, so how do we treat it?

Madeline McCrary, assistant professor of medicine at Washington University in St. Louis, determines one option.

Leah Madeline McCrary is an Assistant Professor in the Division of Infectious Diseases at WashU Medicine. She specializes in infectious complications of substance use, including Hepatitis C and Serratia endocarditis, and works to expand access to treatment for people who use drugs, pregnant individuals, and rural populations. She is currently collaborating to integrate infectious disease care into perinatal substance use programs to improve Hepatitis C treatment during and after pregnancy.

Hepatitis C is a viral infection that can damage the liver and, if untreated, lead to cirrhosis, cancer, or even death. Many people are first diagnosed during pregnancy. The stakes are high—not only for mothers, but also for babies: the virus can be passed from mother to child, with a transmission rate of about 1 in 10.

Unfortunately, treatment often never begins. Insurance may end, follow-up gets missed, or the demands of the postpartum period make clinic visits difficult. As a result, some women return for a second or third pregnancy still infected, despite the availability of a highly effective cure.

But curing hepatitis C protects more than just one person. It prevents long-term complications, reduces household transmission, and lowers the risk of passing the virus to future children.

To address this gap, we partnered across maternal–fetal medicine and infectious diseases to pilot a new approach. Instead of referring mothers to outpatient clinics, we offered hepatitis C treatment at the bedside before hospital discharge. We also used streamlined referrals and telehealth, building on earlier work.

We reviewed records from 149 women diagnosed with hepatitis C during pregnancy. Those who began treatment in the hospital were about twice as likely to complete therapy and be cured, compared to those referred to outpatient care. More than half in the outpatient group never even attended their first appointment.

Treating hepatitis C before discharge helps reduce loss to follow-up, increases cure rates, and protects long-term health. And the impact goes beyond the individual—by curing the infection, we protect families and future pregnancies.

This success was possible through collaboration across specialties. With new guidelines supporting treatment during pregnancy, the goal ahead is clear: cure should be the norm, not the exception.

Read More:

[WashU Medicine] - Innovative approach helps new mothers get hepatitis C treatment

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Madeline McCrary, Washington University in St. Louis - Breaking the Cycle: Hepatitis C Treatment at the Bedside for Pregnant Women

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Madeline McCrary, Washington University in St. Louis - Breaking the Cycle: Hepatitis C Treatment at the Bedside for Pregnant Women