Antenatal screening for hepatitis C: Universal or risk factor based?

作者：Wilson Erin; Beckmann Michael^*

来源：Australian & New Zealand Journal of Obstetrics & Gynaecology, 2015, 55(4): 318-322.

DOI：10.1111/ajo.12296

• Hepatitis C
• mass screening
• pregnancy
• prenatal diagnosis
• risk factors

Background: There is no clear consensus on whether antenatal screening for hepatitis C (HCV) should be universal, or based on an assessment of risk factors.
Aim: To report the HCV status and risk factors for HCV amongst women delivering at a tertiary metropolitan hospital in order to better understand the implications of changing from universal to risk factor based HCV screening.
Materials and Methods: An audit of practice was performed at Mater Mothers' Hospitals (Brisbane) using routinely collected data from 2007 to 2013 (n=57,659). The demographic and clinical characteristics of HCV-positive women (n=281) were compared with those with a negative result (n=57,378), and compared for the presence or absence of risk factors for HCV.
Results: From a cohort of 57,659 women, 281 (0.5%) women were HCV positive. HCV-positive women were more likely to have received blood products (10.0 vs 3.1%; P<0.001), have a history of illicit drug use (72.2 vs 9.8%; P<0.001), and have at least one risk factor for HCV infection (92 vs 17%; P<0.001). Of the HCV-positive women, only seven of the 281 (2.5%) had no identifiable risk factor, whilst most (83%) HCV-negative women did not have any documented risk factor for HCV infection.
Conclusion: Most women testing positive for HCV antibodies have identifiable risk factors; however, a small number will not be detected if a risk factor based screening approach is adopted. The benefits of universal screening must be weighed against the potential cost savings of a risk factor based screening program.

• 出版日期2015-8