Hepatitis C infection among pregnant women in central Poland: Significance of epidemiological anamnesis and impact of screening tests to detect infection

Abstract

Background. Mother-to-child transmission is one of the main sources of hepatitis C virus (HCV) infection in children. However, because of the asymptomatic course of the illness, certain women may not be aware of their infection.Objectives. The aim of this study was to estimate the significance of epidemiological anamnesis in diagnoses of HCV infection in women of reproductive age and to evaluate how screening among pregnant women impacts the detection of HCV infection.Material and methods. Epidemiological interviews of 432 mothers infected with HCV (but free of human immunodeficiency virus (HIV)) were conducted in the Warsaw Hospital for Infectious Diseases (Poland) from 1998 to 2012.Results. Complaints or abnormalities in laboratory tests were the reasons for anti-HCV antibody testing in 28.2% of mothers, whereas specific interview responses or occupational health care services group affiliation were the reasons for testing in 35.6%. However, in a large group of women, infection was only detected because of screening examinations. The introduction of routine screening for pregnant women (since 2010 in Poland) has led to the increased detection of HCV infection in women who did not present with infection risk factors (9.9% before 2010 vs 46. 1% after 2010). This practice has also led to an increase in the percentage of women diagnosed during pregnancy (21.5% before 2010 vs 30.8% after 2010). Conclusions.Establishing HCV infection risk factors during the interview process is the most common indicator for serological testing; however, not all infected cases can be diagnosed in this manner. Screening for anti-HCV antibodies in pregnant women increases the detection of HCV infection in this group.

Hepatitis C Virus Infection in Children and Pregnant Women: An Updated Review of the Literature on Screening and Treatments

“…In Poland, the introduction of routine screening in 2010 was associated with an increase in the percentage of HCV-positive women who were diagnosed during pregnancy (as opposed to before or after pregnancy). 7 Compared with universal screening of pregnant women, risk-factor-based screening is not effective. 8 Vertical transmission of HCV occurs in 5 to 15% of pregnant women infected with the virus.…”

“…34 From 2011 to 2016 in the United States, HCV testing among children increased by 25% (from 0.47 to 0.59%), and positivity increased by 13% (from 3.6 to 4.0%). 7 The main risk factors for HCV infection in children are tumors, transfusions, and related treatments, 35,36 and having a mother with HCV infection. 37 The risk of MTCT of HCV is associated with maternal HIV coinfection, and with maternal HCV RNA levels.…”

Attitudes and Opinions of Young Gynecologists on Pregnancy Termination: Results of a Cross-Sectional Survey in Poland

“…In addition to malformations, the contraction of infectious diseases that can be transmitted to the fetus [15] and the need to carry out treatments with drugs that can harm the newborn, must be taken into consideration for the termination of pregnancy. In Poland, the screening routine of hepatitis C virus (HCV)was introduced in pregnant women in 2010, to prevent mother-to-child transmission [16].…”

Hepatitis C Virus in Pregnancy: A Systematic Review of the Literature

“…Furthermore, some of the risk factors included in our screening guidelines may not be screened for adequately. Illicit drug use, one of the strongest predictors for HCV infection, [8][9][10][11][12][13][14][15][16][17][18][19][20] is largely a self-reported metric as it is not standard protocol to universally drug-screen pregnant patients via laboratory analysis. It has been shown that patients under-report this behavior 48 which leads to underscreening of this very highrisk population by standard risk screening questionnaire.…”