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A rapid review of antenatal hepatitis C virus testing in the United Kingdom
M P Hibbert1,2, R Simmons3,4, S Mandal3,4
1Sexually Transmitted Infections and HIV Division, Blood Safety, Health Security Agency (UKHSA), Hepatitis, London, England, UK. matthew.hibbert@ukhsa.gov.uk.
Insights
Antenatal screening for hepatitis C virus (HCV) in the UK shows test positivity rates of 0.38% for antibodies and 0.22% for RNA. This highlights the potential of antenatal testing to find new cases and meet elimination targets.
Area of Science:
- Hepatology
- Public Health
- Virology
Background:
- The UK aims to eliminate viral hepatitis, aligning with WHO targets.
- New strategies like antenatal testing are crucial for achieving these elimination goals.
- Understanding hepatitis C virus (HCV) prevalence in pregnant populations is key.
Conclusions:
- Antenatal testing is a vital tool for identifying new hepatitis C cases.
- The contribution of universal opt-out antenatal testing for HCV warrants reconsideration.
- Implementing antenatal screening can significantly aid in achieving viral hepatitis elimination targets.
Background:
The United Kingdom (UK) has committed to the World Health Organization's viral hepatitis elimination targets. New case finding strategies, such as antenatal testing, may be needed to achieve these targets. We conducted a rapid review to understand hepatitis C-specific antibody (anti-HCV) and HCV RNA test positivity in antenatal settings in the United Kingdom to inform guidance.
Methods:
Articles and conference abstracts published between January 2000 and June 2022 reporting anti-HCV testing in antenatal settings were identified through PubMed and Web of Science searches. Results were synthesised using a narrative approach.
Results:
The search identified 2,011 publications; 10 studies were included in the final synthesis. Seven studies used anonymous testing methods and three studies used universal opt-out testing. Anti-HCV test positivity ranged from 0.1 to 0.99%, with a median value of 0.38%. Five studies reported HCV RNA positivity, which ranged from 0.1 to 0.57% of the testing population, with a median value of 0.22%. One study reported cost effectiveness of HCV and found it to be cost effective at £9,139 per quality adjusted life years.
Conclusion:
The relative contribution of universal opt-out antenatal testing for HCV should be reconsidered, as antenatal testing could play an important role in new case-finding and aid achieving elimination targets.
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