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New guidelines boosted hepatitis C virus (HCV) screening in pregnant individuals, but significant disparities by insurance type persist. Universal screening remains an unmet goal despite progress.

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Health Services Research

Background:

  • Hepatitis C virus (HCV) infection poses risks during pregnancy.
  • Updated screening recommendations aim to improve early detection and management.
  • Understanding the impact of these recommendations on screening rates and disparities is crucial.

Purpose of the Study:

  • To evaluate the national impact of the 2020 Centers for Disease Control and Prevention (CDC) and U.S. Preventive Services Task Force (USPSTF) recommendations on HCV screening among pregnant persons.
  • To analyze screening trends based on health insurance type (Medicaid vs. commercial).

Main Methods:

  • Retrospective cohort study using Quest Diagnostics data from January 2011 to June 2021.
  • Included 5,048,428 pregnant individuals aged 15-44 years with Medicaid or commercial insurance.
  • Analyzed trends in HCV antibody screening before and after the 2020 recommendations.

Main Results:

  • HCV antibody screening rates increased before and accelerated after the early 2020 recommendations.
  • Substantial disparities in HCV testing rates were observed between individuals with Medicaid and commercial insurance throughout the study period.
  • Despite improvements, current screening proportions do not meet universal recommendation levels.

Conclusions:

  • The 2020 CDC/USPSTF recommendations have positively influenced HCV screening among pregnant individuals.
  • Persistent disparities highlight the need for targeted interventions to ensure equitable screening access.
  • Further efforts are required to achieve universal HCV screening in pregnant populations.