Program Schedule

1002
Active Screening Strategies and Education for Hepatitis C Infected Pregnant Women are Needed to Improve the Identification of Hepatitis C Exposed Newborns

Session: Poster Abstract Session: Pediatric - Viral Studies
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • Hepatitis C Screening Pregnant Women and Newborns.pdf (48.0 kB)
  • Background: Hepatitis C virus (HCV) infection is a silent disease and major public health concern that affects ~3.2 million, making it the most common chronic blood borne infection in the US.  While most children acquire HCV perinatally, without appropriate maternal screening, <5% of cases are identified.  The American Academy of Pediatrics and Centers for Disease Control and Prevention (CDC) recommend testing of all infants born to mothers with HCV, yet CDC and American College of Obstetrics and Gynecology (ACOG) recommend testing only high risk pregnant women. The objective of this study was to improve identification of HCV exposed newborns.

    Methods: The project was conducted in 2 phases. Intervention 1: An educational handout regarding testing of newborns exposed to HCV was developed and given to HCV positive mothers after delivery along with an appointment for testing the newborn.  HCV testing and newborn follow-up data were analyzed pre-intervention (Jan-Dec 2012) and post-intervention (Jan-Dec 2013).  Intervention 2:  To further improve identification of HCV exposed newborns, collaborative measures between Obstetrics (OB) and Pediatric Infectious Disease programs, were implemented.  A HCV risk screening questionnaire based on ACOG recommendations was administered to all pregnant women attending a university OB clinic. Women identifying risk factors were tested for HCV antibody. Results from pre-intervention (Jan-Mar 2013) and post-intervention (Jan-Mar 2014) periods were compared.

    Results: Prior to intervention 1, 3 (23%) of 13 newborns were tested and all were negative. After intervention 1, 14 (50%) of 28 newborns were tested, 1 was HCV PCR positive. Prior to intervention 2, only 8 (0.7%) of 1112 pregnant women were tested for HCV and all were negative, compared to 116 (12%) of 977 women after intervention 2 (p<.0001, chi-square test). 7 (6%) were HCV antibody positive. 

    Conclusion: Our data suggest that educational handouts improve HCV testing of exposed newborns. In addition, many HCV infected pregnant women and their exposed newborns would not be identified unless active interventions for screening are in place. Universal testing of pregnant women may be a better strategy to identify HCV exposed newborns.

    Leigh Bragg, MD1, Ayesha Mirza, MD1, Kelly Best, MD2 and Tiffannie Walker, MD2, (1)Pediatric Infectious Diseases & Immunology, University of Florida College of Medicine - Jacksonville, Jacksonville, FL, (2)Obstetrics & Gynecology, University of Florida College of Medicine - Jacksonville, Jacksonville, FL

    Disclosures:

    L. Bragg, None

    A. Mirza, None

    K. Best, None

    T. Walker, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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