Researchers and clinicians at WashU Medicine are helping reshape how hepatitis C virus (HCV) is treated during pregnancy, with a new study showing that a commonly used antiviral regimen can be used safely and effectively in pregnant patients in real-world care.
The study examined the use of glecaprevir-pibrentasvir, an oral HCV treatment, in 14 pregnant patients treated between 14 and 32 weeks of gestation. Of the 14 patients prescribed the medication, 10 completed the treatment. All ten of those patients achieved virologic response by the time of delivery or earlier. Investigators reported no maternal or neonatal safety concerns, adding to growing evidence that HCV treatment during pregnancy may be feasible when carefully managed through shared decision-making. Their findings are published in Clinical Infectious Diseases.
The findings are especially meaningful because, until now, there had been no clinical trial data and no real-world experience published for glecaprevir-pibrentasvir treatment in pregnancy. The study helps fill an important gap for clinicians caring for pregnant patients with HCV, a population that has historically had limited treatment options during pregnancy despite the potential benefits of reducing maternal infection and preventing transmission to infants. “We hope this data will help other clinicians as they engage in treatment discussions with their pregnant patients,” said co-author Laura Marks, MD, PhD, an assistant professor of medicine at WashU Medicine.
The work is part of a broader effort led by WashU Medicine teams in infectious diseases and maternal health to improve care for patients across the region. “We really reach people in St. Louis, all over Missouri, and in southern Illinois,” said co-author Madeline McCrary, MD, an assistant professor of medicine. The project brings together medication research, implementation science, and health economics to build a new model of care for HCV in pregnancy.
Researchers say the collaboration has already produced multiple papers spanning treatment outcomes, implementation of the new care model, and its cost-effectiveness. Together, they point to a growing local effort with potential implications far beyond the region — one that could help expand access to HCV treatment for pregnant patients while improving outcomes for families.
L Madeline McCrary, Megan R Curtis, Jeannie C Kelly, Jessica Elrod-Gallegos, Patrick Kojima, Patricia Werner, Jennifer L Mullersman, Tracey Habrock-Bach, Michael J Durkin, Laura R Marks, Real-World Experience of Hepatitis C Treatment With Glecaprevir-Pibrentasvir During Pregnancy, Clinical Infectious Diseases, 2026; ciag422, https://doi.org/10.1093/cid/ciag422
Financial support. Supported for this work came from the National Institutes of Health (NIH) (grants R21 DA057493, R01 HD113199, and R61 DA062321 to J. C. K.), the National Institute of Allergy and Infectious Diseases, NIH (grant 5P30AI176532 to M. J. D.), and the National Institute on Drug Abuse, NIH (grant K12 DA054999 to M. R. C.).