Understanding current antenatal Hepatitis C testing and care in maternity services in England

Area of Science:

• Hepatology
• Public Health
• Maternal Medicine

Background:

• Current guidelines recommend risk-based antenatal screening for Hepatitis C virus (HCV) instead of universal opt-out testing.
• Maternity services' adherence to these testing guidelines requires investigation.

Purpose of the Study:

• To assess current antenatal HCV testing practices among maternity service providers in England.
• To evaluate adherence to existing HCV testing guidance and identify gaps in care.

Main Methods:

• A cross-sectional survey was distributed to English maternity service providers from November to December 2020.
• The survey collected data on testing policies, staff training, and management protocols for HCV-positive pregnant women.

Main Results:

• 87% of responding providers offered antenatal HCV risk-based testing, with 48% of English services represented.
• Significant variation exists in the risk factors identified for testing.
• Vulnerable groups such as homeless individuals or those with a history of incarceration were infrequently identified as high-risk.

Conclusions:

• Current antenatal HCV testing practices are insufficient, leading to potential undiagnosed HCV infections in pregnant women, particularly among vulnerable groups.
• There is a need to re-evaluate and enhance risk-based antenatal HCV testing strategies.
• Developing specific HCV pathway guidance for maternity units is crucial for improving diagnosis and management.