Addressing the Disease Burden of Vertically Acquired Hepatitis C Virus Infection Among Opioid-Exposed Infants.

Autor: Protopapas S; Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.; Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Murrison LB; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.; Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Wexelblatt SL; Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Blackard JT; Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Hall ES; Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.; Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2019 Oct 21; Vol. 6 (12), pp. ofz448. Date of Electronic Publication: 2019 Oct 21 (Print Publication: 2019).
DOI: 10.1093/ofid/ofz448
Abstrakt: Background: This study aims to estimate the disease burden of vertically acquired hepatitis C virus (HCV) in a large Midwestern hospital and to identify factors associated with HCV diagnostic testing among high-risk infants.
Methods: This is a retrospective analysis of an infant cohort (n = 58 427) born from 2014 to 2016 in the Greater Cincinnati region, where universal maternal urine testing is conducted at delivery to assess for intrauterine drug exposure (IUDE). Demographics and birth characteristics were analyzed among high-risk infants to identify factors associated with receiving HCV testing. A nested, matched, case-control analysis examined the association of pediatric HCV infection and IUDE.
Results: The HCV prevalence rate among high-risk infants who received testing was 3.6%-5.2% of births. Approximately 66.7% of maternally acquired HCV infections may be missed using current testing recommendations. Prenatal care had no significant effect (adjusted odds ratio [aOR], 1.2; 95% confidence interval [CI], 0.4-3.5) on the odds of a high-risk infant receiving HCV testing. Opioid-exposed cases had a more than 6-fold increase in the odds of HCV infection (aOR, 6.2; 95% CI, 2.3-16.6]) compared with nonopioid exposed infants.
Conclusions: The IUDE was significantly associated with increased odds of pediatric HCV infection in this population. The gaps in pediatric HCV testing identified in this study, despite known risk level and maternal infection, suggest the need for increased focus on HCV identification in the pediatric population.
(© The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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