862: A cost-effectiveness analysis of universal Hepatitis C screening in all US pregnancies
Current American College of Obstetricians and Gynecologists recommend limiting hepatitis C (HCV) screening during pregnancy to high-risk groups only. We sought to evaluate the cost effectiveness of universal screening among all pregnant persons.
There is worldwide enthusiasm for the elimination of hepatitis C (HCV). The availability of highly effective and safe direct acting anti-viral agents to treat almost everyone with HCV infection means that HCV elimination is now primarily a public health challenge. Making progress towards HCV elimination requires screening to increase the proportion of HCV-infected persons who are aware of their status, linking to and retaining them in care to achieve cure, and increasing access to harm reduction services to prevent new infections.
ConclusionThis case highlights and adds to the growing body of evidence supporting the need for universal screening for hepatitis C in ICP patients and the potential role for repeat SBA testing, which would be a notable change from the traditional care of these individuals.
Authors: Ifeorah IM, Bakarey AS, Akubo AO, Onyemelukwe FN Abstract Hepatitis C virus (HCV) is associated with liver complicated diseases resulting in end-stage hepatocellular carcinoma. Although vertical transmission from mother to child serves as one of the routes of HCV acquisition in children, yet HCV infection in pregnant women and children is still underappreciated in sub-Saharan Africa. Therefore, this study investigated the burden of HCV, associated risk factors, and viremia among antenatal and postnatal clinic attendees in the rural and urban communities of Kogi State, Nigeria. Atotal of 176 blood samples w...
CONCLUSION: The reported prevalence of maternal HCV infection has increased 161% from 2009 to 2017. PMID: 31923064 [PubMed - as supplied by publisher]
Chronic hepatitis C virus (HCV) infection is characterized by persistent high-level viremia and defective cellular immunity, including a lack of functional HCV-specific CD4+ T cells. We previously described an exceptional period of viral control that occurs in some chronically infected women after childbirth. Here, we investigated whether reduced HCV replication after pregnancy is associated with recovery of CD4+ T cell immunity. Class II tetramer analysis revealed significantly greater frequencies of circulating HCV-specific CD4+ T cells at 3 months postpartum in women with concurrent declines in viremia compared with tho...
Parenteral transmission is the major route of hepatitis C virus transmission in adults; however, vertical transmission is most common in children. There are several factors that have been shown to be associated with vertical transmission of hepatitis C virus, including hepatitis C virus RNA, human immunodeficiency virus coinfection, and peripheral blood mononuclear cell infection. As there is no effective vaccine to prevent hepatitis C virus infection, and there are no human data describing the safety of the new direct acting antiviral agents in pregnancy, the only preventive strategy for vertical transmission is to treat ...
SMFM currently recommends anti-HCV antibody testing in pregnant patients with risk factors (RFs). However, due to HCV prevalence and 95-99% cure rates using antiviral treatments, universal testing is in question. Recently (2019), there have been 2 publications on universal HCV testing using simulation models both reporting cost-effectiveness. However, through a literature search, we did not find any large prospective study evaluating actual capture rates (&cost-effectiveness) comparing testing based on RFs vs.
Although the prevalence of Hepatitis C (HCV) infection is increasing in young women in the US, the effects of HCV on pregnancy and perinatal outcomes are poorly defined. We compared maternal and neonatal outcomes between women with a positive HCV screen (HCV+) and those in a general obstetric population to further define adverse perinatal outcomes associated with HCV+ in pregnancy.
Despite increasing prevalence of Hepatitis C (HCV) infection in young women in the US, risk-based screening for HCV in pregnancy remains the standard. We compared characteristics of women who underwent risk-based versus universal HCV screening in pregnancy.
Due to increasing incidence of Hepatitis C (HCV) infection in younger populations, there is increased interest in screening in pregnancy, linkage to care, and postpartum treatment. However, the care cascade prospects in this population are poorly understood. We aimed to identify maternal sociodemographic (SD) and pregnancy characteristics in HCV-infected women associated with successful follow-up and initiation of HCV treatment.