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Hepatitis C Testing Among Perinatally Exposed Infants.

Susan M Lopata1,2, Elizabeth McNeer3,4, Judith A Dudley5

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Hepatitis C virus (HCV) testing for exposed infants is low, with only 23% tested. Testing rates are lower for African American infants, highlighting a need to improve public health systems for better infant screening.

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Area of Science:

  • Hepatology
  • Pediatrics
  • Public Health

Background:

  • Hepatitis C virus (HCV) prevalence in pregnant women doubled between 2009 and 2014.
  • Infants born to HCV-infected mothers are at risk of vertical transmission.
  • National guidelines recommend HCV testing for exposed infants, but adherence is unclear.

Purpose of the Study:

  • To determine the rate of HCV testing in infants exposed to the virus.
  • To identify hospital- and patient-level factors associated with HCV testing disparities.

Main Methods:

  • Retrospective cohort study using Tennessee Medicaid data (2005-2014).
  • Inclusion of 4072 infants exposed to HCV, followed up to age 2.
  • Multilevel logistic regression to analyze testing predictors.

Main Results:

  • Only 23% of infants exposed to HCV received testing.
  • White, tobacco-using, and HIV-positive mothers had higher rates of infant testing.
  • African American infants were less likely to be tested (adjusted odds ratio 0.32).

Conclusions:

  • HCV testing rates for exposed infants are suboptimal, with less than 1 in 4 tested.
  • Significant disparities exist, with African American infants being tested less frequently.
  • Public health systems require strengthening to ensure universal HCV testing for at-risk infants.