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.
The aim of our study was to examine the clinical characteristics of pregnant women with ICP and HCV infection.
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.
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).
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.