An evaluation of hepatitis C virus screening in infants born to seropositive mothers

Angela Morris (a), Dr. Sarah Gander (a,b,c,d), and Sarah Campbell (b,d)
(a) Dalhousie Medicine New Brunswick
(b) Department of Pediatrics, Saint John Regional Hospital, Horizon Health Network
​(c) Centre for Research Education and Clinical Care of At-Risk Populations (RECAP)
(d) New Brunswick Social Pediatrics Research Program 

​The primary route of Hepatitis C Virus (HCV) infection in infants is through vertical transmission, from mother-to-child, which occurs at an estimated rate of 5.8%. The objective of the current study was to evaluate the rates of screening for at-risk infants and determine if custodianship impacts infant screening rate. Active charts at the Centre for Research, Education & Clinical Care of At-Risk Populations (RECAP) were reviewed to identify infants born to HCV seropositive women at-risk for vertical transmission. Information collected included maternal HCV genotype, non-prescription drug use, transfusion history, income quintile and opiate substitution therapy. A 2x2 chi-square test was performed to assess the frequency of HCV screening status by the presence or absence of custodianship issues. HCV status at the time of pregnancy (N = 62 mothers, 123 pregnancies) revealed 18 (14.6%) with a positive HCV screen, 14 (11.4%) with a positive viral load, and 91 (74.0%) with results unknown (no testing prior to infant date of birth or unknown infant date of birth). A total of 30 infants had HCV screening performed (N = 123), of which 3 (10.0%) were HCV-antibody positive and had a detectable viral load. The presence or absence of custodianship issues was found to be non-significant. Improvements in chart documentation are essential to determine HCV status at the time of pregnancy and provide per child clarity on issues of custodianship. Further work on effective care pathways are needed to ensure vertical transmission of HCV is detected and treated appropriately.