Evaluation of Prenatal Hepatitis C Virus Prevalence Using Universal Screening, and Linkage to Care in a Real-World Setting in Ontario.

Autor:	Biondi MJ; Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON; School of Nursing, York University, Toronto, ON. Electronic address: mbiondi@yorku.ca., Lynch K; Obstetrics and Gynecology, London Health Sciences Centre, London, ON., Floriancic N; Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON., Cronin K; Public Health Ontario Laboratories, Toronto, ON., Marchand-Austin A; Public Health Ontario Laboratories, Toronto, ON., Mendlowitz AB; Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON., Capraru C; Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON., Kozak RA; Sunnybrook Health Sciences Centre, Toronto, ON., Goneau L; Public Health Ontario Laboratories, Toronto, ON., Tran V; Public Health Ontario Laboratories, Toronto, ON., Mazzulli T; Public Health Ontario Laboratories, Toronto, ON; Department of Microbiology, University Health Network/Sinai Health System, Toronto, ON., Yudin MH; St. Michael's Hospital, Unity Health Toronto, Toronto, ON., Hansen B; Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON., Eastabrook G; Obstetrics and Gynecology, London Health Sciences Centre, London, ON., Feld JJ; Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON.
Jazyk:	angličtina
Zdroj:	Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC [J Obstet Gynaecol Can] 2024 Jun; Vol. 46 (6), pp. 102423. Date of Electronic Publication: 2024 Mar 05.
DOI:	10.1016/j.jogc.2024.102423
Abstrakt:	Objectives: International infectious disease/obstetrical societies have recently recommended universal hepatitis C virus (HCV) prenatal screening and these same recommendations are forthcoming in Canada. At present, there is no formal analysis of universal HCV screening or linkage to care of pregnant people in Ontario. The objectives of our study were to determine the seroprevalence of HCV using 2 different methods to evaluate universal screening, as well as identify opportunities that may improve linkage to care. Methods: To assess seroprevalence in a large urban area, we aimed to test 12 000 de-identified samples submitted for prenatal HIV testing in the catchment area of Toronto Public Health for HCV antibodies. Then, to assess the seroprevalence as well as the operational impact and follow-up in a real-world setting, we completed a Quality Improvement Project (QIP) for 1 year at a large tertiary care obstetrical centre in London, Ontario. Results: From 2019 to 2021, 11 999 de-identified samples were screened from Toronto with a seroprevalence of 0.40 (95% CI 0.29-0.53). In London, 5771 people were screened in 2021 with a seroprevalence of 0.55% (95% CI 0.38-0.78). Taken together, those aged 26-35 years had the highest positivity; in the QIP, 9% had no documented risk factor, and 59% of individuals were not linked to the next step in HCV care. Conclusions: HCV prenatal seroprevalence in Ontario is comparable to hepatitis B virus, and ∼15-30-fold higher than HIV. Diagnosis in pregnancy is critical to facilitate referrals for treatment between pregnancies and could increase screening among children born to positive women. (Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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