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. 2017 Mar 31;5(1):27-33.
doi: 10.1515/jtim-2017-0001. eCollection 2017 Mar.

Ongoing Transmission of HCV: Should Cesarean Section be Justified? Data Mining Discovery

Abd Elrazek  1 , Samy Saab  2 , Mahmoud Foad  3 , Elsayed A Elgohary  4 , Mohammad M Sallam  4 , Abdallah Nawara  4 , Ali Ismael  4 , Samar S Morsi  5 , Altaher Salah  6 , Mohamed Alboraie  7 , Akshaya Srikanth Bhagavathula  8 , Marwa Zayed  9 , Hossam Elmasry  10 , Tamer Z Salem  11
Affiliations

Ongoing Transmission of HCV: Should Cesarean Section be Justified? Data Mining Discovery

Abd Elrazek et al. J Transl Int Med. .

Abstract

Background and objectives: Over the past few decades, cesarean section (CS) rates are steadily increasing in most of the middle- and high-income countries. However, most of the pregnant women (particularly undergoing CS) are not screened for hepatitis C virus (HCV); hence, neonates born to HCV-positive mother could be a source of future HCV infection. In this study, the role of the CS and other surgical interventions in HCV transmission in Egypt, the highest endemic country of HCV-4, was investigated.

Methods: From January to June 2016, a prospective cohort study was conducted among 3,836 pregnant women in both urban and rural areas across Egypt for HCV screening in both mothers and neonates born to HCV-positive mother. All pregnant women were screened during third trimester or just before delivery, neonates born to HCV-positive mothers were evaluated within 24-h postdelivery to record vertical transmission cases. Data mining (DM)-driven computational analysis was used to quantify the findings.

Results: Among 3,836 randomized pregnant women, HCV genotype 4 was identified in 80 women (2.08%). Out of 80 HCV-infected women, 18 have experienced surgical intervention (22.5%) and 62 CS (77.5%). HCV vertical transmission was identified in 10 neonates, 10/80 (12.5%).

Conclusion: Screening women who had experienced surgical intervention or CS during child bearing period and before pregnancy might prevent HCV mother-to-child transmission (MTCT). CS should be ethically justified to decrease global HCV transmission.

Keywords: Cesarean Section; data mining; hepatitis C virus; pregnant women; vertical transmission.

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Conflict of interest statement

Conflict of interest All authors declare no conflict of interest

Figures

Figure 1
Figure 1
Modified decision tree modified by Rapid I, Berlin, Germany, showing the most independent factor for HCV ongoing transmission. PCR: polymerase chain reaction; HCV: hepatitis C virus; ELISA: enzyme-linked immunosorbent assay.
Figure 2
Figure 2
Simple distribution Naïve Bayes diagram created by Rapid I version 4.6 shows the level of maternal HCV G4 related vertical transmission; > 3× 106 IU should be considered as the high level of vertical prediction. PCR, polymerase chain reaction
Figure 3
Figure 3
Global HCV transmission—based on MTCT.
See this image and copyright information in PMC

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