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Clinics and Research in Hepatology and Gastroenterology
Volume 41, n° 1
pages 39-45 (février 2017)
Doi : 10.1016/j.clinre.2016.07.004
Hepatitis C infection and intrahepatic cholestasis of pregnancy: A systematic review and meta-analysis

Karn Wijarnpreecha a, , Charat Thongprayoon a, Anawin Sanguankeo a, b, Sikarin Upala a, b, Patompong Ungprasert c, d, Wisit Cheungpasitporn c
a Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA 
b Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand 
c Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA 
d Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 

Corresponding author at: One Atwell Road, Cooperstown, NY 13326, USA.One Atwell RoadCooperstownNY13326USA

Hepatitis C virus (HCV) infection is a major cause of cirrhosis worldwide. Several studies have linked HCV infection to a higher risk of developing intrahepatic cholestasis of pregnancy (ICP), but some data demonstrates contradictory results. To further investigate the association and estimated risk of ICP in patients with HCV infection, we conducted this meta-analysis to summarize all available evidence.


This study consists of two meta-analyses. A literature search was performed using MEDLINE and EMBASE from inception to January 2016. The first study included observational studies that reported relative risks, odds ratios, or hazard ratios of the associations between HCV infection and risk of ICP. The second analysis included studies comparing the risk of later HCV infection in ICP patients with those without ICP. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random-effect, generic inverse variance method.


Three studies were included in the first analysis. The pooled OR of ICP in HCV-infected pregnant women compared to non-HCV pregnant women was 20.40 (95% CI, 9.39–44.33, I 2=55%). Two studies were included in the second analysis. The pooled OR of later HCV infection among ICP patients compared to non-ICP patients was 4.08 (95% CI, 3.13–5.31, I 2=0%).


Our meta-analysis demonstrates not only a higher risk of ICP among HCV-infected pregnant women but also an increased risk of later HCV infection among ICP patients. These findings suggest potential benefits of screening for hepatitis C in women with signs of ICP.

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