No Wrong Door to Accessing Hepatitis C Treatment in Pregnancy

Pregnant women with hepatitis C (HCV) were excluded from clinical trials of curative antiviral therapy and therefore Australian guidelines recommend against treatment of HCV during pregnancy and breastfeeding, leading to inequitable access to HCV treatment. There's a triple benefit of treating HCV during pregnancy - cure for mother, reduced risk of transmission to fetus, and public health benefit. Treatment of women during pregnancy with the attendant mitigation of perinatal HCV transmission has been neglected but is essential to achieving Australian and international HCV elimination goals. International guidelines recognise the emerging data of safety and efficacy of HCV treatment during pregnancy and the potential benefits described above and now recommend shared decision making with regards to HCV treatment during pregnancy. Our previous work demonstrated women prioritise antenatal care over care for their other health conditions during pregnancy, and therefore to implement HCV treatment during pregnancy it is imperative to bring HCV care to women where they access antenatal care. While the idea of integration of HCV and maternity care may be a solution to increasing access to HCV treatment for women, it is unclear whether this is feasible or acceptable to maternity care providers or to women with HCV in Australia. This project seeks to better understand barriers and enablers to treatment of HCV during pregnancy from the perspectives of both maternity care providers and pregnant women with HCV, increase access to HCV treatment, and reduce perinatal transmission of HCV.