More than 80% of infants born to mothers with HCV go untested for vertical transmission in the Philadelphia area, according to recent research in Clinical Infectious Diseases.
“Our findings demonstrate that many health care providers remain unaware of both the risks of perinatal HCV transmission and the recommended protocols for testing exposed infants,” Danica E. Kuncio, MPH, hepatitis epidemiologist for the Philadelphia Department of Public Health, told Infectious Diseases in Children. “Although there is HCV testing being performed on women of child-bearing age, positive results are still not being appropriately relayed to pediatricians.
Danica E. Kuncio
“This break in communication means that a high proportion of HCV-positive children remain unidentified and out of care for their HCV infection. Improving infant testing rates will be especially critical once direct-acting antiviral agents against HCV are approved for pediatric use.”
Kuncio and colleagues analyzed data from an electronic hepatitis registry, a database reported to the city’s health department that monitors HCV-positive patients. Birth certificates for 2011 to 2013 were matched with HCV data to identify the testing status of children aged 20 months or older. The researchers also retrospectively examined additional tests, including negative results. Results were compared with the expected vertical HCV transmission rate of 5% to estimate the number of children with unidentified HCV infections.
Study data revealed that 500 women registered with the HCV dataset gave birth to one or more children from 2011 to 2013. Of the 537 at-risk children born during this period, only 16% were tested for HCV infection, resulting in four confirmed cases. Based on comparisons to the expected rate of infection, the researchers estimated that there are 24 unidentified children with chronic HCV infection.
“It is important for both patients and providers to be aware of the risks of vertical HCV transmission, and to understand the steps required to identify children perinatally infected with HCV,” Kuncio and colleagues wrote. “As a part of standard health care, women should be encouraged to communicate their HCV infection statuses to relevant providers. In addition, health care providers of mother and child must … adequately test every child who is exposed to HCV.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.