OBJECTIVE: To describe the patterns of screening for hepatitis C virus (HCV) infection in methadone-maintained pregnant women and their infants. DESIGN, SETTING AND PATIENTS: Retrospective review of medical records from one rural and two metropolitan hospitals in New South Wales for pregnant women on methadone maintenance treatment and infants born to these women between 1 January 2000 and 31 December 2006, as well as records for pregnant women who were not on methadone treatment. MAIN OUTCOME MEASURES: Rates of anti-HCV antibody and HCV RNA testing for pregnant women and their infants, and ages at which infants attended follow-up appointments. RESULTS: Of 295 pregnant women on methadone maintenance treatment, 288 were tested for anti-HCV antibodies (98%), compared with 1995 of 9987 women who were not on methadone treatment (20%) (P<0.001). Seropositive results were obtained for 243 women in the methadone group (84%) and 54 in the non-methadone group (3%) (P<0.001), of whom 44 (18%) and 17 (31%), respectively, were subsequently tested for HCV RNA (P=0.03). HCV RNA test results were positive for 31 (70%) and 10 (59%) seropositive women in the methadone and non-methadone groups, respectively (P=0.39). Of infants of HCV-seropositive methadone-maintained mothers, 27% of those for whom we had follow-up attendance data received HCV screening, and one of these infants tested positive for anti-HCV antibodies and HCV RNA. CONCLUSIONS: Screening for HCV infection in the high-risk population of pregnant women on methadone maintenance treatment and their infants is inadequate. This could lead to significant underdetection of active HCV infection in this high-risk population, and their infants. Current screening guidelines may therefore need to be revised.
OBJECTIVE: To describe the patterns of screening for hepatitis C virus (HCV) infection in methadone-maintained pregnant women and their infants. DESIGN, SETTING AND PATIENTS: Retrospective review of medical records from one rural and two metropolitan hospitals in New South Wales for pregnant women on methadone maintenance treatment and infants born to these women between 1 January 2000 and 31 December 2006, as well as records for pregnant women who were not on methadone treatment. MAIN OUTCOME MEASURES: Rates of anti-HCV antibody and HCV RNA testing for pregnant women and their infants, and ages at which infants attended follow-up appointments. RESULTS: Of 295 pregnant women on methadone maintenance treatment, 288 were tested for anti-HCV antibodies (98%), compared with 1995 of 9987 women who were not on methadone treatment (20%) (P<0.001). Seropositive results were obtained for 243 women in the methadone group (84%) and 54 in the non-methadone group (3%) (P<0.001), of whom 44 (18%) and 17 (31%), respectively, were subsequently tested for HCV RNA (P=0.03). HCV RNA test results were positive for 31 (70%) and 10 (59%) seropositive women in the methadone and non-methadone groups, respectively (P=0.39). Of infants of HCV-seropositive methadone-maintained mothers, 27% of those for whom we had follow-up attendance data received HCV screening, and one of these infants tested positive for anti-HCV antibodies and HCV RNA. CONCLUSIONS: Screening for HCV infection in the high-risk population of pregnant women on methadone maintenance treatment and their infants is inadequate. This could lead to significant underdetection of active HCV infection in this high-risk population, and their infants. Current screening guidelines may therefore need to be revised.
Authors: Elizabeth E Krans; Scott D Rothenberger; Penelope K Morrison; Seo Young Park; Leah C Klocke; Mary J Turocy; Susan Zickmund Journal: Matern Child Health J Date: 2018-08
Authors: Elizabeth E Krans; Susan L Zickmund; Vinod K Rustgi; Seo Young Park; Shannon L Dunn; Eleanor B Schwarz Journal: Subst Abus Date: 2015-11-16 Impact factor: 3.716
Authors: Rachel L Epstein; Vishakha Sabharwal; Elisha M Wachman; Kelley A Saia; Claudia Vellozzi; Susan Hariri; Benjamin P Linas Journal: J Pediatr Date: 2018-08-28 Impact factor: 6.314