Sexually Transmitted Infections and HIV Division, Blood Safety, Health Security Agency (UKHSA), Hepatitis, London, England, UK.
National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted, Infections at University College London in partnership with UKHSA, London, England.
BMC Pregnancy Childbirth. 2023 Nov 28;23(1):823. doi: 10.1186/s12884-023-06127-x.
The United Kingdom (UK) has committed to the World Health Organization's viral hepatitis elimination targets. New case finding strategies, such as antenatal testing, may be needed to achieve these targets. We conducted a rapid review to understand hepatitis C-specific antibody (anti-HCV) and HCV RNA test positivity in antenatal settings in the United Kingdom to inform guidance.
Articles and conference abstracts published between January 2000 and June 2022 reporting anti-HCV testing in antenatal settings were identified through PubMed and Web of Science searches. Results were synthesised using a narrative approach.
The search identified 2,011 publications; 10 studies were included in the final synthesis. Seven studies used anonymous testing methods and three studies used universal opt-out testing. Anti-HCV test positivity ranged from 0.1 to 0.99%, with a median value of 0.38%. Five studies reported HCV RNA positivity, which ranged from 0.1 to 0.57% of the testing population, with a median value of 0.22%. One study reported cost effectiveness of HCV and found it to be cost effective at £9,139 per quality adjusted life years.
The relative contribution of universal opt-out antenatal testing for HCV should be reconsidered, as antenatal testing could play an important role in new case-finding and aid achieving elimination targets.
英国承诺实现世界卫生组织的病毒性肝炎消除目标。为实现这些目标,可能需要采用新的病例发现策略,如产前检测。我们进行了一项快速综述,以了解英国产前环境中丙型肝炎病毒特异性抗体(抗-HCV)和丙型肝炎病毒 RNA 检测阳性情况,为指南提供依据。
通过 PubMed 和 Web of Science 搜索,确定了 2000 年 1 月至 2022 年 6 月期间发表的报告产前环境中抗-HCV 检测的文章和会议摘要。使用叙述性方法综合结果。
搜索共确定了 2011 篇出版物;最终综合分析纳入了 10 项研究。其中 7 项研究使用匿名检测方法,3 项研究使用普遍选择退出检测。抗-HCV 检测阳性率范围为 0.1%至 0.99%,中位数为 0.38%。5 项研究报告了 HCV RNA 阳性率,检测人群的阳性率范围为 0.1%至 0.57%,中位数为 0.22%。其中一项研究报告了丙型肝炎病毒的成本效益,发现其每增加一个质量调整生命年的成本为 9139 英镑,具有成本效益。
应重新考虑普遍选择退出的产前 HCV 检测的相对贡献,因为产前检测可能在新病例发现中发挥重要作用,并有助于实现消除目标。