5719 HIV/STD/Viral Hepatitis Section, Division of Communicable and Environmental Disease and Emergency Preparedness, Tennessee Department of Health, Nashville, TN, USA.
12328 Vanderbilt Center for Child Health Policy, Departments of Pediatrics and Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA.
Public Health Rep. 2022 Sep-Oct;137(5):860-866. doi: 10.1177/00333549211035854. Epub 2021 Aug 17.
Maternal hepatitis C virus (HCV) infection reported on birth certificates has been shown to underestimate HCV infection. We sought to determine the usefulness of HCV surveillance data for (1) quantifying the number of HCV-positive reproductive-aged women with a live birth, (2) comparing maternal HCV surveillance data with reported HCV infection status on birth certificates, and (3) delineating past versus current maternal infection to identify true perinatal exposures.
We extracted data from January 1, 2013, through December 31, 2017, on birth certificate indication of HCV exposure from the Tennessee Birth Statistical File, and we ascertained indication of HCV exposure by using laboratory data from the Tennessee National Electronic Disease Surveillance System (NEDSS) Base System (NBS). We conducted a sensitivity analysis comparing birth certificate indication of HCV exposure with HCV laboratory data to determine whether true perinatal exposure had occurred.
During the study period, 6731 mothers with live births in Tennessee reported having HCV infection during pregnancy: 3295 (49.0%) had both laboratory and birth certificate indication of HCV infection, 2130 (31.6%) had indication of HCV infection on the laboratory report only, and 1306 (19.4%) had indication of HCV infection on the birth certificate only.
Using data from a public health HCV surveillance system with birth certificate data may improve the identification of HCV-infected pregnant women and perinatally exposed infants. Surveillance systems that include complete reporting of all HCV RNA results can be used to distinguish past from present maternal HCV infection to focus limited public health resources on currently infected mothers and their exposed infants.
出生证明上报告的母体丙型肝炎病毒（HCV）感染已被证明低估了 HCV 感染。我们旨在确定 HCV 监测数据的以下用途：（1）量化具有活产的 HCV 阳性育龄妇女数量；（2）比较 HCV 监测数据与出生证明上报告的 HCV 感染状况；（3）描绘过去与现在的产妇感染，以确定真正的围产期暴露。
我们从田纳西州出生统计档案中提取了 2013 年 1 月 1 日至 2017 年 12 月 31 日期间的出生证明 HCV 暴露指示数据，并通过田纳西州国家电子疾病监测系统（NEDSS）基础系统（NBS）的实验室数据确定 HCV 暴露指示。我们进行了一项敏感性分析，将出生证明 HCV 暴露指示与 HCV 实验室数据进行比较，以确定是否发生了真正的围产期暴露。
在研究期间，田纳西州有 6731 名活产母亲报告在怀孕期间患有 HCV 感染：3295 名（49.0%）既有实验室和出生证明 HCV 感染指示，2130 名（31.6%）仅有实验室 HCV 感染指示，1306 名（19.4%）仅有出生证明 HCV 感染指示。
使用公共卫生 HCV 监测系统与出生证明数据相结合，可以提高 HCV 感染孕妇和围产期暴露婴儿的识别率。监测系统应完整报告所有 HCV RNA 结果，以便区分过去和现在的产妇 HCV 感染，将有限的公共卫生资源集中用于目前感染的母亲及其暴露婴儿。
