Hepatitis C: is there a case for universal screening in pregnancy?

Area of Science:

• Hepatology
• Infectious Diseases
• Maternal Health

Background:

• Hepatitis C (HCV) screening during pregnancy is not universally applied, with many hospitals using targeted approaches.
• A shift from targeted to universal antenatal screening for HCV occurred at a Dublin maternity hospital between 2006 and 2007.

Purpose of the Study:

• To audit and compare the effectiveness of targeted versus universal antenatal screening for Hepatitis C.
• To evaluate the prevalence and detection rates of HCV in an antenatal population under different screening policies.

Main Methods:

• A retrospective audit of two consecutive years (2006 and 2007) of antenatal screening data.
• Analysis of HCV prevalence and RNA positivity rates comparing targeted (2006) and universal (2007) screening policies.

Main Results:

• HCV prevalence was 1.4% in 2006 (targeted) and 0.71% in 2007 (universal).
• One case in 2007 would have been missed by targeted screening (1.49% of targeted cases).
• HCV-RNA positivity rates were similar: 55% in 2006 and 57.5% in 2007.

Conclusions:

• Antenatal Hepatitis C screening detection rates were comparable between targeted and universal policies.
• Universal screening may not be essential if targeted screening employs inclusive criteria, but it is valuable for research.
• The study highlights the importance of effective screening strategies for maternal and infant health regarding HCV.