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了解英格兰产科学服务中当前的产前丙型肝炎检测和护理情况。

Understanding current antenatal Hepatitis C testing and care in maternity services in England.

机构信息

Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency (UKHSA), London, UK.

NHS England & NHS Improvement, HCV Elimination, London, UK.

出版信息

J Perinat Med. 2024 Apr 22;52(5):515-519. doi: 10.1515/jpm-2023-0508. Print 2024 Jun 25.

Abstract

OBJECTIVES

Universal opt-out antenatal screening for Hepatitis C virus (HCV) is not currently recommened and it is recommended that maternity services offer risk-based testing. We aimed to investigate antenatal HCV testing and adherence to testing guidance.

METHODS

A cross-sectional survey was circulated to maternity service providers between November-December 2020 which included testing policy, training for healthcare staff, and management of women found to be HCV positive. Descriptive data are presented.

RESULTS

A total of 75 questionnaires were returned, representing 48 % of English maternity service providers. 87 % of providers reported offering antenatal HCV risk-based testing. Risk factors used to identify pregnant women for testing varied. Less than 15 % of respondents considered women that were ever homeless or with history of incarceraton or from higher HCV prevalence areas as high risk.

CONCLUSIONS

Current antenatal HCV testing practices are inadequate and HCV infection likely goes undiagnosed in pregnancy, especially among vulnerable population groups. In the absence of universal antenatal screening, re-framing antenatal HCV risk-based testing and management as a quality improvement initiative and developing HCV specific pathway guidance for maternity units is required.

摘要

目的

目前不建议普遍采用自愿选择的产前丙型肝炎病毒(HCV)筛查,而建议母婴保健服务提供基于风险的检测。我们旨在调查产前 HCV 检测情况和对检测指南的遵循情况。

方法

2020 年 11 月至 12 月,向母婴保健服务提供者进行了一项横断面调查,内容包括检测政策、医护人员培训以及发现 HCV 阳性妇女的管理。报告了描述性数据。

结果

共收回 75 份问卷,代表了 48%的英国母婴保健服务提供者。87%的提供者报告提供了基于风险的产前 HCV 检测。用于识别孕妇进行检测的风险因素各不相同。不到 15%的受访者认为曾经无家可归、有监禁史或来自 HCV 高流行地区的妇女属于高风险人群。

结论

目前的产前 HCV 检测做法不足,怀孕期间 HCV 感染可能未被诊断,尤其是在弱势群体中。在没有普遍进行产前筛查的情况下,需要将基于风险的产前 HCV 检测和管理重新定义为一项质量改进举措,并为母婴单位制定 HCV 专项途径指南。

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