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. 2020 Mar;145(3):e20192482.
doi: 10.1542/peds.2019-2482. Epub 2020 Feb 14.

Hepatitis C Testing Among Perinatally Exposed Infants

Susan M Lopata  1   2 , Elizabeth McNeer  3   4 , Judith A Dudley  5 , Carolyn Wester  6 , William O Cooper  7   3   5 , James G Carlucci  7   8 , Claudia M Espinosa  9   10 , William Dupont  4   5 , Stephen W Patrick  7   2   3   5
Affiliations

Hepatitis C Testing Among Perinatally Exposed Infants

Susan M Lopata et al. Pediatrics. 2020 Mar.

Abstract

Background: Hepatitis C virus (HCV) prevalence doubled among pregnant women from 2009 to 2014, reaching 3.4 per 1000 births nationwide. Infants exposed to HCV may acquire HCV by vertical transmission. National guidelines recommend that infants exposed to HCV be tested; however, it is unclear if these recommendations are being followed. Our objectives were to determine if infants exposed to HCV were tested and to determine hospital- and patient-level factors associated with differences in testing.

Methods: In this retrospective cohort study of infants exposed to HCV who were enrolled in the Tennessee Medicaid program, we used vital statistics-linked administrative data for infants born between January 1, 2005, and December 31, 2014. Infants were followed until 2 years old. Multilevel logistic regression was used to assess the association of HCV testing and hospital- and patient-level characteristics.

Results: Only 23% of 4072 infants exposed to HCV were tested. Infants whose mothers were white versus African American (96.6% vs 3.1%; P <.001), used tobacco (78% vs 70%; P <.001), and had HIV (1.3% vs 0.4%; P = .002) were more likely to be tested. Infants exposed to HCV who had a higher median of well-child visits (7 vs 6; P <.001) were more likely to be tested. After accounting for maternal and infant characteristics and health care use patterns, African American infants were less likely to undergo general testing (adjusted odds ratio 0.32; 95% confidence interval, 0.13-0.78).

Conclusions: Testing occurred in <1 in 4 infants exposed to HCV and less frequently among African American infants. Public health systems need to be bolstered to ensure that infants exposed to HCV are tested for seroconversion.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Espinosa has received grant support from Gilead. Gilead did not support any aspect of conceptualization or development of this article; the other authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Number of infants exposed to HCV per 1000 live births in Tennessee by county, 2005–2014.
FIGURE 2
FIGURE 2
Testing of infants exposed to HCV.
See this image and copyright information in PMC

Comment in

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