Grant: Travel Awards - Institute Community Support

Treatment in pregnancy requires serious consideration to address loss to follow-up postpartum, as prenatal care may be the only time one is engaged with the healthcare system. Interestingly, recent findings have shown that a viral load of 6.0 log10 IU/ml may be predictive of vertical transmission which may suggest that treatment in the prenatal period could decrease transmission (similar to HIV and HBV). The American Guidelines from AASLD recommend a case-by-case decision making process for treatment in pregnancy, and providers in Canada and globally have started to initiate HCV treatment in pregnancy as a part of routine care. Large interventional studies are also underway, and thus far there have been no major safety concerns, cure rates have been 100%, and no child has acquired HCV to date. As providers are starting to offer treatment in pregnancy, it will be important to gather the data and follow these patients to understand whether there is overall maternal and pediatric benefit to treatment in pregnancy. Similarly, understanding women's motivation to undergo HCV treatment or choosing not to be treated during pregnancy is critical to developing pathways to link women to care, expedite the HCV care cascade to prevent lost to follow up and essentially prevent vertical transmission in their current pregnancy and in subsequent pregnancies. This work will provide valuable information, expand evidence-based treatment practices, and inform health care providers, policy analysts and governments to create pathways and comprehensive programs for vulnerable pregnant and postpartum women living with HCV. Furthermore, by interviewing pregnant women living with HCV, we hope to better understand the reasons one would choose to be treated or not in pregnancy.