Infant follow-up postdelivery from a hepatitis C viral load positive mother

J Matern Fetal Neonatal Med. 2019 Oct;32(19):3303-3305. doi: 10.1080/14767058.2018.1458836. Epub 2018 Apr 18.

Abstract

Objective: The primary current recommendation for infant follow-up postdelivery from a hepatitis C virus (HCV) viral load positive mother is to evaluate for the presence of antibody at or after 18 months of age. Our study objective was to analyze compliance with this recommendation for postdelivery infant HCV screening at our institution among a cohort of infants delivered from HCV viral load positive mothers. Methods: Starting 1 January, 2015, a prospective database was developed for all pregnancies that involved mothers with a positive HCV viral load during pregnancy. This short report describes the infant follow-up for deliveries through 30 June, 2016. At hospital discharge, all neonates were given follow-up pediatric appointments and mothers were supplied the date and time of the appointment along with the pediatric group name, office directions, and phone number. Statistics involved simple percentages with Poisson binomial 95% confidence intervals. Results: A total of 127 newborns were delivered of HCV viral load positive mothers during the study period and 55 (43%, 95% CI 35-52%) attended their pediatric appointments and were still in follow-up. Regarding the 72 cases (57%, 95% CI 48-65%) not in follow-up, 24 (19%, 95% CI 13-27%) never presented to care and 48 (38%, 95% CI 29-47%) came to one or two visits shortly after delivery but were absent for further follow-up. Conclusions: These data demonstrate that follow-up at 18 months postdelivery from an HCV viral load positive mother occurs in less than half of the cases and alternative screening strategies should be evaluated.

Keywords: Hepatitis C testing in pregnancy; pediatric care for children infected with hepatitis C; perinatal transmission of hepatitis C; viral hepatitis in infants; viral hepatitis in pregnancy.

MeSH terms

  • Adult
  • Cohort Studies
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Guideline Adherence / statistics & numerical data
  • Hepacivirus / immunology
  • Hepatitis C / diagnosis*
  • Hepatitis C / epidemiology
  • Hepatitis C / transmission*
  • Hepatitis C / virology
  • Humans
  • Immunoglobulins / analysis
  • Immunoglobulins / blood
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical* / statistics & numerical data
  • Male
  • Monitoring, Physiologic* / methods
  • Monitoring, Physiologic* / standards
  • Monitoring, Physiologic* / statistics & numerical data
  • Pregnancy
  • Pregnancy Complications, Infectious* / blood
  • Pregnancy Complications, Infectious* / diagnosis
  • Pregnancy Complications, Infectious* / epidemiology
  • Pregnancy Complications, Infectious* / virology
  • Serologic Tests
  • Viral Load* / methods
  • Viral Load* / standards

Substances

  • Immunoglobulins