Hepatitis C Virus Testing in Perinatally Exposed Children

Area of Science:

• Hepatology
• Public Health
• Pediatrics

Background:

• Rising hepatitis C virus (HCV) incidence in pregnant individuals leads to increased perinatal exposure.
• Fewer than 50% of perinatally exposed infants receive recommended HCV testing.
• Limited data exist on testing rates, treatment, and associated factors for infants with perinatal HCV exposure.

Purpose of the Study:

• To identify factors associated with appropriate HCV testing in perinatally exposed infants.
• To characterize the HCV care and treatment landscape for children diagnosed with HCV.
• To inform strategies for improving early detection and management of perinatal HCV.

Main Methods:

• A cohort study utilizing linked statewide health data in Massachusetts (2014-2021).
• Included records on testing, care, and treatment for children perinatally exposed to HCV.
• Multivariable logistic regression analyzed factors associated with guideline-concordant HCV testing.

Main Results:

• Of 4103 children aged ≥2 years, only 41.9% completed appropriate HCV testing.
• HCV was diagnosed in 2.5% of tested children; treatment rates were very low.
• Appropriate testing rates declined over time, with the lowest observed in 2020.
• Parental HCV diagnosis within 30 days of delivery and maternal opioid use disorder treatment were linked to higher testing rates.
• Non-Hispanic Black race and private insurance were associated with lower testing rates.

Conclusions:

• HCV testing and treatment rates for perinatally exposed infants remain suboptimal and have decreased over time.
• Parental HCV diagnosis recognition and communication are crucial modifiable factors for increasing testing.
• Addressing disparities and improving care coordination are essential for equitable HCV testing and management in infants.