Charlotta Millbourn1,2,3, Charlotte Lybeck4, Afrodite Psaros Einberg5,6, Margareta Nordin7, Gudrun Lindh1, Ingegerd Hökeberg8, Hans Fredlund9, Björn Fischler5,6, Helena Fadl10, Ann-Sofi Duberg4, Karin Lindahl1,2. 1. Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden. 2. Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Huddinge, Sweden. 3. Department of Infectious Diseases, Danderyd Hospital, Stockholm, Sweden. 4. Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 5. Department of Clinical Science, Intervention and Technology, CLINTEC, Stockholm, Sweden. 6. Department of Pediatrics, Karolinska University Hospital, Stockholm, Sweden. 7. Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden. 8. Department of Communicable Disease Prevention and Control, Stockholm County Council, Stockholm, Sweden. 9. Department of Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 10. Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Abstract
BACKGROUND: The hepatitis C virus (HCV) prevalence in Sweden is estimated to be <0.5%, but unclear in pregnant women. The dominating route of transmission is drug use (DU), blood transfusions constituted a risk before 1992. The aim was to examine the anti-HCV prevalence and risk factors for HCV among pregnant women and their partners to evaluate screening strategies. METHODS: Pregnant women and partners in Örebro County and in southern Stockholm were offered HCV-screening when visiting an antenatal clinic in 2013-2016, and completed a questionnaire concerning the country of birth, knowledge of HCV-status and HCV risk factors. RESULTS: In Örebro 2,827 pregnant women and 707 partners, and in Stockholm 1,281 pregnant women and 320 partners participated. Anti-HCV was positive in 34 (0.7%) (25 pregnant women) and the associated risk factors were DU (n = 27), partner with HCV (n = 24) and not born in Sweden (n = 8). HCV RNA was positive in 23 (0.4%), 4 previously unknown and 10 who had been lost to follow-up. The most effective risk factor-based screening model for pregnant women included DU, blood transfusions, born in high prevalence country, partner with HCV, resulting in 538 (13%) pregnant women tested with 96% sensitivity, 87% specificity. CONCLUSIONS: In this study of expecting parents in two Swedish regions, the anti-HCV prevalence was 0.7% and 0.4% were viraemic, of which about 60% were previously unknown or lost to follow-up. Awaiting more studies, including cost-benefit analysis evaluating universal screening, we recommend this improved risk factor-based screening model to identify HCV-infected individuals who need follow-up and therapy.
BACKGROUND: The hepatitis C virus (HCV) prevalence in Sweden is estimated to be <0.5%, but unclear in pregnant women. The dominating route of transmission is drug use (DU), blood transfusions constituted a risk before 1992. The aim was to examine the anti-HCV prevalence and risk factors for HCV among pregnant women and their partners to evaluate screening strategies. METHODS: Pregnant women and partners in Örebro County and in southern Stockholm were offered HCV-screening when visiting an antenatal clinic in 2013-2016, and completed a questionnaire concerning the country of birth, knowledge of HCV-status and HCV risk factors. RESULTS: In Örebro 2,827 pregnant women and 707 partners, and in Stockholm 1,281 pregnant women and 320 partners participated. Anti-HCV was positive in 34 (0.7%) (25 pregnant women) and the associated risk factors were DU (n = 27), partner with HCV (n = 24) and not born in Sweden (n = 8). HCV RNA was positive in 23 (0.4%), 4 previously unknown and 10 who had been lost to follow-up. The most effective risk factor-based screening model for pregnant women included DU, blood transfusions, born in high prevalence country, partner with HCV, resulting in 538 (13%) pregnant women tested with 96% sensitivity, 87% specificity. CONCLUSIONS: In this study of expecting parents in two Swedish regions, the anti-HCV prevalence was 0.7% and 0.4% were viraemic, of which about 60% were previously unknown or lost to follow-up. Awaiting more studies, including cost-benefit analysis evaluating universal screening, we recommend this improved risk factor-based screening model to identify HCV-infected individuals who need follow-up and therapy.
Authors: Sarah Blach; Marianne Blomé; Ann-Sofi Duberg; Anna Jerkeman; Martin Kåberg; Per-Erik Klasa; Martin Lagging; Devin Razavi-Shearer; Homie Razavi; Soo Aleman Journal: Liver Int Date: 2021-06-30 Impact factor: 8.754
Authors: Arpan A Patel; Aileen Bui; Eian Prohl; Debika Bhattacharya; Su Wang; Andrea D Branch; Ponni V Perumalswami Journal: Hepatol Commun Date: 2020-12-07