Hepatitis B and C: value of universal antenatal screening

To determine the positive yield of universal antenatal screening of hepatitis B and C and its association with known risk factors.

Cross-sectional, analytical study.

The study was conducted from January to December 2006 at Zainab Panjwani Memorial Hospital, Karachi.

All pregnant women were screened for hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) antibodies during antenatal period irrespective of the presence of known risk factors. Carriers i.e. women whose HBV or HCV infection positive status was already laboratory confirmed on first antenatal visit were excluded. Screening was performed by Acu-check one strip test (chromatographic immunoassay) in serum. Women screened positive were interviewed, a questionnaire was filled inquiring about the history of any risk factors predisposing to these infections. Frequency of positive cases was determined in those with risk factors and those without. The proportion was compared using Chi-square test.

Of the 2592 pregnant women screened during the study period, 09 (0.34%) were HBsAg positive and 18 (0.69%) were HCV antibodies positive. None was found to be a carrier of both viruses. There were 1004 primigravidas, who had no recallable risk factor, and of those, 02 (0.19%) and 09 (0.89%) were HBV and HCV carriers respectively. No significant association of risk factors was seen in both HBV (p=0.310) and HCV (p=0.328).

There was no significant association of risk factors with HBV and HCV infection, thus necessitating the need of universal antenatal screening. However, large scale epidemiological/multicentric studies are required to determine the cost-effectiveness of the screening and prevention of vertical transmission.