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

J Perinat Med. 2024 Apr 22;52(5):515-519. doi: 10.1515/jpm-2023-0508. Print 2024 Jun 25.

Abstract

Objectives: Universal opt-out antenatal screening for Hepatitis C virus (HCV) is not currently recommened and it is recommended that maternity services offer risk-based testing. We aimed to investigate antenatal HCV testing and adherence to testing guidance.

Methods: A cross-sectional survey was circulated to maternity service providers between November-December 2020 which included testing policy, training for healthcare staff, and management of women found to be HCV positive. Descriptive data are presented.

Results: A total of 75 questionnaires were returned, representing 48 % of English maternity service providers. 87 % of providers reported offering antenatal HCV risk-based testing. Risk factors used to identify pregnant women for testing varied. Less than 15 % of respondents considered women that were ever homeless or with history of incarceraton or from higher HCV prevalence areas as high risk.

Conclusions: Current antenatal HCV testing practices are inadequate and HCV infection likely goes undiagnosed in pregnancy, especially among vulnerable population groups. In the absence of universal antenatal screening, re-framing antenatal HCV risk-based testing and management as a quality improvement initiative and developing HCV specific pathway guidance for maternity units is required.

Keywords: HCV infection; Hepatitis C; United Kingdom; antenatal testing; pregnancy; survey.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • England / epidemiology
  • Female
  • Hepatitis C* / diagnosis
  • Hepatitis C* / epidemiology
  • Hepatitis C* / therapy
  • Humans
  • Maternal Health Services / standards
  • Pregnancy
  • Pregnancy Complications, Infectious* / diagnosis
  • Pregnancy Complications, Infectious* / epidemiology
  • Pregnancy Complications, Infectious* / therapy
  • Prenatal Care / methods
  • Prenatal Care / standards
  • Prenatal Diagnosis / methods
  • Surveys and Questionnaires