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. 2023 Feb 28;6(1):70-75.
doi: 10.3138/canlivj-2022-0017. eCollection 2023 Feb.

Prevalence of syphilis coinfection in hepatitis C virus positive prenatal patients from Alberta during a pilot routine screening program

L Alexa Thompson  1   2 , Sabrina S Plitt  3   4 , Jennifer Gratrix  5 , Carmen L Charlton  1   2   6   7
Affiliations

Prevalence of syphilis coinfection in hepatitis C virus positive prenatal patients from Alberta during a pilot routine screening program

L Alexa Thompson et al. Can Liver J. .

Abstract

BACKGROUND: Alberta routinely screens pregnant patients for select communicable diseases. Hepatitis C virus (HCV) was added to the prenatal screening panel as part of a provincial pilot program in February 2020. This retrospective cross-sectional study aimed to characterize the prevalence of syphilis coinfections in prenatal patients infected with HCV following implementation of the pilot program.METHODS: Routine prenatal HCV and syphilis testing data were extracted from the Public Health Laboratory Information System over a 21-month period. HCV positivity was defined as HCV enzyme immunoassay (EIA) reactive with detected HCV ribonucleic acid (RNA) following molecular confirmation, and positive results were examined for syphilis coinfections. All patients reactive on a syphilis EIA and confirmatory Treponema pallidum particle agglutination (TPPA) or follow-up rapid plasma reagin (RPR) test were considered positive for syphilis. Descriptive statistics for coinfected patients were analyzed. RESULTS: Eighty-seven prenatal patients were identified to be positive for HCV. Of those, 19 (21.8%) were reactive on the syphilis EIA and 17 (19.5%) had confirmed infections with the TPPA or RPR tests. For HCV/syphilis coinfected patients, the majority resided in metropolitan regions (64.6%), were from the lowest income quintile neighbourhoods (47.1%) and had previously tested positive for HCV (82.4%) and syphilis (64.6%) at the public health laboratory. CONCLUSIONS: The prevalence of syphilis coinfections in prenatal patients infected with HCV is high in Alberta. HCV/syphilis coinfection prevalence should be further investigated in other jurisdictions and prenatal cohorts to better understand testing and treatment options for prevention of congenital transmission.

Keywords: Alberta; coinfection; hepatitis C virus (HCV); prenatal; screening; syphilis.

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Figures

Figure 1:
Figure 1:
Analysis of syphilis coinfections among a cohort of prenatal patients infected with HCV in Alberta; syphilis infections were defined as either newly identified cases with newly reactive EIA and TPPA results or previously identified patients whose RPR results were ≥4-fold increase in quantitative titres from previous serological testing
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References

    1. Alberta Health. Alberta prenatal screening guidelines for select communicable diseases. 2018. https://open.alberta.ca/dataset/0ac7acb6-dc90-4133-8f63-5946d4bbf4d1/res.... (Accessed January 22, 2022).
    1. Boucher M, Gruslin A. The reproductive care of women living with hepatitis C infection. J Obstet Gynaecol Can. 2017;39(7):E1–E25. 10.1016/j.jogc.2017.04.007. Medline: - DOI - PubMed
    1. Government of Canada. Report on hepatitis B and C surveillance in Canada. 2019. https://www.canada.ca/en/public-health/services/publications/diseases-co.... (Accessed December 3, 2021).
    1. Government of Alberta. Interactive health data application. http://www.ahw.gov.ab.ca/IHDA_Retrieval/redirectToURL.do?cat=81&subCat=1110 (Accessed January 24, 2022).
    1. Alberta Precision Laboratories. Laboratory bulletin: Changes to the prenatal testing requisition. 2020. https://www.albertahealthservices.ca/assets/wf/lab/wf-lab-bulletin-chang.... (Accessed July 19, 2022).

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