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Vertical transmission of hepatitis C: Testing and health-care engagement
Sharon Reid1,2, Carolyn A Day3, David G Bowen4
1Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Insights
Hepatitis C virus (HCV) testing for infants born to infected mothers was often incomplete, posing a risk. Ensuring complete HCV testing for at-risk children is crucial.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Hepatitis C virus (HCV) infection during pregnancy poses risks for both mother and child.
- Understanding testing patterns and healthcare engagement is vital for managing vertical transmission and ensuring child health.
Purpose of the Study:
- To examine hepatitis C virus (HCV) testing practices and healthcare access for anti-HCV positive pregnant women and their children.
- To track testing and engagement from pregnancy through the child's first two years of life.
Main Methods:
- A cohort study was conducted at an Australian inner-city hospital between 2010 and 2012.
- Data were collected from 29 anti-HCV positive pregnant women and their 31 children via questionnaires and medical records.
Main Results:
- HCV RNA was detected in 64% of pregnancies, with injecting drug use identified as a likely transmission route.
- Maternal healthcare engagement decreased post-delivery; ongoing drug use was common.
- Only 10% of children received complete HCV testing, with 58% receiving partial testing; no vertical transmission was found.
Conclusions:
- Inadequate or incomplete HCV testing of vulnerable children is a significant concern.
- Factors like maternal drug use, reduced healthcare engagement, and out-of-home-care placement increase risk.
- Complete HCV testing for all children at risk of vertical transmission must be prioritized.
Aim:
To investigate hepatitis C virus (HCV) testing patterns and engagement with health care for women positive for HCV antibodies (anti-HCV) in pregnancy and their children through pregnancy and the first 2 years of the child's life.
Methods:
At a large inner-city Australian hospital from 2010 to 2012, anti-HCV positive pregnant women were recruited into a cohort study from pregnancy to 2 years post-delivery. Maternal and child data were collected by questionnaire and medical record extraction.
Results:
During the study 29 women participants delivered 31 children. HCV RNA was detected in 64% (18/28) of pregnancies, with injecting drug use, the most likely route of maternal infection. Relatively high maternal health-care engagement during pregnancy reduced after delivery. There was evidence of ongoing illicit drug use in the majority of women. Of the children, 58% (18/31) had some HCV testing confirmed but complete testing was confirmed for only 10% (3/31). Largely, testing was incomplete or unknown. No vertical transmission was identified. Forty-two percent (13/31) of children were placed in out-of-home-care.
Conclusions:
Potentially, there is a high risk of inadequate or incomplete HCV testing of vulnerable children. Ongoing maternal drug use, poor maternal health-care engagement and placement in out-of-home-care may increase the risk. Complete testing of all children at risk of vertically acquired HCV needs to be ensured.
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