Intrahepatic cholestasis of pregnancy with concomitant hepatitis C virus infection, Joan C. Edwards SOM, Marshall University

Abstract

BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is characterized by pruritus, otherwise unexplained deranged liver enzyme levels, and elevated levels of serum bile acid. ICP has been observed more commonly in hepatitis C virus (HCV) infected women than in women with no HCV infection, and some experts advocate testing for HCV infection in all patients with ICP. AIMS: The aim of our study was to examine the clinical characteristics of pregnant women with ICP and HCV infection. METHODS: We reviewed the records of pregnant women between 18 and 45 years of age over a period of 6 years with an International Classification of Diseases, Ninth Revision (ICD-9) diagnosis of HCV infection, ICP, or both. We collected demographic, clinical, and financial data on all the patients and compared them with and without a diagnosis of ICP. RESULTS: There were 91 pregnant women with a diagnosis of HCV, and 41 (45%) of these women were diagnosed with ICP. HCV-infected patients with ICP had a significantly higher median viral load compared with those without ICP (495,000 vs. 8000 copies/ml, P<0.001). The median total financial charges spent for the care of ICP patients with HCV infection was significantly higher than that spent on ICP patients without HCV infection ($12,753.00 vs. $8970.00, P=0.01). CONCLUSION: We found a high prevalence of ICP among pregnant women infected with HCV, and those with ICP had a higher HCV viral load. Women with suspected ICP should be tested for the presence of HCV.