Infant follow-up postdelivery from a hepatitis C viral load positive mother
Craig V Towers1, Kimberly B Fortner1
1a Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine , University of Tennessee Medical Center , Knoxville , TN , USA.
Insights
Hepatitis C virus (HCV) antibody screening for infants born to HCV-positive mothers shows low follow-up rates, with less than half completing the recommended 18-month evaluation. Alternative screening strategies are needed.
Area of Science:
- Hepatology
- Pediatric Infectious Diseases
- Public Health
Background:
- Hepatitis C virus (HCV) infection poses risks to newborns from infected mothers.
- Current guidelines recommend infant antibody testing at 18 months post-delivery for maternal HCV.
- Compliance with these recommendations is crucial for early detection and management.
Purpose of the Study:
- To assess adherence to the 18-month infant follow-up screening for Hepatitis C virus (HCV).
- To analyze the rates of infant follow-up for deliveries from mothers with a positive HCV viral load.
- To identify barriers to infant follow-up care in this specific cohort.
Main Methods:
- Prospective database established for pregnancies with maternal HCV viral load positivity.
- Infant follow-up data collected for deliveries between January 2015 and June 2016.
- Simple percentages and Poisson binomial 95% confidence intervals used for statistical analysis.
Main Results:
- 127 infants were born to mothers with positive HCV viral load.
- Only 55 infants (43%) completed recommended pediatric appointments and remained in follow-up.
- A significant proportion (57%) were lost to follow-up, with many attending only initial visits.
Conclusions:
- Infant follow-up for Hepatitis C virus (HCV) screening at 18 months is achieved in less than half of cases.
- Current follow-up protocols demonstrate low compliance rates.
- Development and evaluation of alternative infant HCV screening strategies are urgently required.
Abstract:
Objective: The primary current recommendation for infant follow-up postdelivery from a hepatitis C virus (HCV) viral load positive mother is to evaluate for the presence of antibody at or after 18 months of age. Our study objective was to analyze compliance with this recommendation for postdelivery infant HCV screening at our institution among a cohort of infants delivered from HCV viral load positive mothers. Methods: Starting 1 January, 2015, a prospective database was developed for all pregnancies that involved mothers with a positive HCV viral load during pregnancy. This short report describes the infant follow-up for deliveries through 30 June, 2016. At hospital discharge, all neonates were given follow-up pediatric appointments and mothers were supplied the date and time of the appointment along with the pediatric group name, office directions, and phone number. Statistics involved simple percentages with Poisson binomial 95% confidence intervals. Results: A total of 127 newborns were delivered of HCV viral load positive mothers during the study period and 55 (43%, 95% CI 35-52%) attended their pediatric appointments and were still in follow-up. Regarding the 72 cases (57%, 95% CI 48-65%) not in follow-up, 24 (19%, 95% CI 13-27%) never presented to care and 48 (38%, 95% CI 29-47%) came to one or two visits shortly after delivery but were absent for further follow-up. Conclusions: These data demonstrate that follow-up at 18 months postdelivery from an HCV viral load positive mother occurs in less than half of the cases and alternative screening strategies should be evaluated.
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