New Treatment Model Enhances Hepatitis C Care for New Mothers

Recent research from Washington University School of Medicine in St. Louis has introduced a transformative approach to treating hepatitis C in postpartum mothers. By allowing these women to begin antiviral treatment during their hospital stay after childbirth, the likelihood of achieving a cure significantly improves.

Hepatitis C, a bloodborne virus that can lead to severe liver complications, remains a significant health challenge, particularly among women of childbearing age. This demographic accounts for over 20% of chronic hepatitis C infections worldwide. Traditionally, treatment for hepatitis C has required outpatient follow-up appointments, which can be difficult to manage in the demanding postpartum period.

The study highlights how initiating treatment while mothers are still hospitalized can dramatically enhance their chances of completing the therapy and being cured. Findings indicate that mothers who received care from an infectious disease specialist during their hospital stay were twice as likely to achieve a cure compared to those who were referred to outpatient appointments.

Laura Marks, the study's senior author, noted that many patients were falling through the cracks due to the traditional separation between inpatient and outpatient care for hepatitis C. The innovative program seeks to bridge this gap by ensuring that mothers have access to necessary treatment at the time of delivery.

Women are often screened for hepatitis C during pregnancy, but treatment has historically been postponed until after childbirth. This can lead to missed opportunities for care, as many women do not return for follow-up once they have delivered. To address this issue, Marks and her team implemented a 'Meds to Beds' initiative. This program enables the maternal care team to coordinate with infectious disease specialists to start treatment before the patient is discharged from the hospital.

In assessing the effectiveness of this program, researchers reviewed the medical records of 149 mothers who delivered at Barnes-Jewish Hospital and tested positive for hepatitis C between January 2020 and September 2023. The results were striking: approximately two-thirds of those who began treatment in the hospital completed the entire course of antiviral medication, compared to only one-third of those referred for outpatient care.

Moreover, over half of the mothers in the outpatient referral group failed to attend their follow-up appointments. Successful treatment was verified through lab tests confirming the absence of hepatitis C or patient self-reporting of treatment adherence.

According to Jeannie Kelly, a collaborator on the project, curing hepatitis C in postpartum mothers has far-reaching implications, not only for their health but also for their families and future pregnancies. The partnership between obstetrics and infectious disease specialists aims to eliminate gaps in care and ensure mothers have the support they need.

Following the success of the initial program, the Division of Infectious Diseases and the Division of Maternal-Fetal Medicine at WashU Medicine are expanding the 'Meds to Beds' model, aiming to apply this approach to all patients with untreated hepatitis C. This initiative has already facilitated bedside delivery of medications to over 200 patients since its inception.

Looking forward, the team is training healthcare providers to implement this model beyond their institution, potentially influencing how infectious diseases are treated in various settings. They emphasize the importance of innovative care models to improve public health outcomes.