Prenatal hepatitis C screening, diagnoses, and follow-up testing in British Columbia, 2008-2019

PLoS One. 2020 Dec 31;15(12):e0244575. doi: 10.1371/journal.pone.0244575. eCollection 2020.

Abstract

Objective: Current guidelines in British Columbia recommend prenatal screening for hepatitis C antibodies (anti-HCV) if risk factors are present. We aimed to estimate frequency of prenatal anti-HCV testing, new diagnoses, repeated and follow-up testing among BC women.

Methods: BC Centre for Disease Control Public Health Laboratory data estimated the number of BC women (assigned female at birth or unknown sex) aged 13-49 who received routine prenatal serological screening (HIV, hepatitis B, syphilis and rubella) from 2008-2019. Anti-HCV tests ordered the same day as routine prenatal screens were considered prenatal anti-HCV tests. Assessment of follow-up was based on HCV RNA and/or genotype testing within one year of new prenatal anti-HCV diagnoses.

Results: In 2019, 55,202 routine prenatal screens were carried out for 50,392 BC women. Prenatal anti-HCV tests increased significantly, from 19.6% (9,704/49,515) in 2008 to 54.6% (27,516/50,392) in 2019 (p<0.001). New prenatal anti-HCV diagnoses (HCV positive diagnoses at first test or seroconversions) declined from 14.3% in 2008 to 10.1% in 2019. The proportion of women with new prenatal anti-HCV diagnoses that were a result of a first HCV test declined from 0.3% (29/9,701) in 2008 to 0.03% (8/27,500) in 2019. For women known to be anti-HCV positive at the time of prenatal screening, the proportion who had a prenatal anti-HCV test increased from 35.6% in 2008 to 50.8% in 2019.

Conclusion: Prenatal anti-HCV testing increased substantially over the study period. However, new HCV diagnoses remained relatively stable, suggesting that a considerable proportion of BC women with low or no risk are being screened as part of prenatal care. The vast majority of women with new HCV diagnoses receive appropriate follow-up HCV RNA and genotype testing, which may indicate interest in HCV treatment. These findings contribute to the discussion around potential for prenatal anti-HCV screening in an effort to eliminate HCV.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • British Columbia / epidemiology
  • Diagnostic Tests, Routine
  • Female
  • Hepacivirus / genetics
  • Hepacivirus / immunology
  • Hepacivirus / isolation & purification*
  • Hepatitis C / diagnosis*
  • Hepatitis C / immunology
  • Hepatitis C Antibodies / metabolism*
  • Humans
  • Infant, Newborn
  • Maternal Age
  • Middle Aged
  • Neonatal Screening
  • Practice Guidelines as Topic
  • Pregnancy
  • Prenatal Diagnosis / statistics & numerical data*
  • RNA, Viral / genetics*
  • Young Adult

Substances

  • Hepatitis C Antibodies
  • RNA, Viral

Grants and funding