Gowda Charitha, Kennedy Samuel, Glover Catherine, Prasad Mona R, Wang Ling, Honegger Jonathan R
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Paediatr Perinat Epidemiol. 2018 Jul;32(4):401-410. doi: 10.1111/ppe.12481. Epub 2018 Jul 4.
Hepatitis C virus (HCV) infection is under-recognized among US adults and children. Prenatal HCV screening may help close the diagnosis gap among women while also identifying at-risk infants. Current surveillance efforts for maternal HCV rely primarily on birth certificate data. We sought a more accurate assessment of HCV prevalence among pregnant women in Ohio by combining existing public health surveillance data.
Vital Statistics (VS) birth certificate data and Ohio Disease Reporting System (ODRS) HCV case data, both available through the Ohio Department of Health, were linked to determine rates of past or present HCV infection among women giving birth from 2012 to 2015 in Ohio, overall and by county. Among women with available test results, the proportion with present HCV infection indicated by detectable viraemia during pregnancy was calculated.
Birth certificate data identified 4695 deliveries to women with past/present HCV infection during the study period. Linkage to ODRS revealed an additional 1778 deliveries to women with past/present infection, including 355 with confirmed viraemia during pregnancy. The prevalence of past/present HCV among pregnant women in Ohio rose from 0.82% in 2012 to 1.54% in 2015.
Maternal HCV infection is under-recognized and increasing in prevalence. Current case identification processes are inadequate in pregnancy, even among women with prior positive HCV testing. Alternative approaches, including enhanced risk factor-based screening or universal prenatal screening in high prevalence settings, are needed to improve rates of HCV recognition among reproductive-aged women and newborns at risk of vertical transmission.
丙型肝炎病毒（HCV）感染在美国成年人和儿童中未得到充分认识。产前HCV筛查可能有助于缩小女性群体中的诊断差距，同时识别有风险的婴儿。目前对孕产妇HCV的监测工作主要依赖出生证明数据。我们通过整合现有公共卫生监测数据，寻求对俄亥俄州孕妇中HCV流行率进行更准确的评估。
通过俄亥俄州卫生部获取的生命统计（VS）出生证明数据和俄亥俄疾病报告系统（ODRS）的HCV病例数据相链接，以确定2012年至2015年在俄亥俄州分娩的女性中过去或当前HCV感染率，整体及按县分别统计。在有可用检测结果的女性中，计算孕期可检测到病毒血症表明当前感染HCV的比例。
出生证明数据识别出在研究期间有4695例分娩的女性曾有过/目前感染HCV。与ODRS数据相链接后发现另外有1778例分娩的女性曾有过/目前感染HCV，其中包括355例孕期病毒血症确诊的病例。俄亥俄州孕妇中过去/当前HCV感染率从2012年的0.82%升至2015年的1.54%。
孕产妇HCV感染未得到充分认识且感染率在上升。当前的病例识别流程在孕期并不充分，即使是之前HCV检测呈阳性的女性。需要采取其他方法，包括在高流行地区加强基于风险因素的筛查或普遍的产前筛查，以提高对有垂直传播风险的育龄妇女和新生儿中HCV的识别率。
