Hepatitis C Virus Testing Among Perinatally Exposed Children: 2018 to 2020

Abstract

Objective: To assess the frequency of hepatitis C virus (HCV) testing among a population-based cohort of perinatally exposed children and identify factors associated with testing.

Methods: Using a population-based surveillance cohort of perinatally exposed children born from 2018 to 2020 from 4 US jurisdictions (Georgia; Massachusetts; Allegheny County, Pennsylvania; and Los Angeles County, California), we describe the frequency, timing, and type of HCV testing among children and identify characteristics associated with having an HCV test result by the age of 2 to 3 years. Data were obtained from electronic laboratory reporting, vital records, and medical records.

Results: Of 803 perinatally exposed children, 7 (1%) died before the age of 24 months. Of 796 children, health departments were unable to find medical records or laboratory reports for 181 (23%). Among those with medical record abstraction at 24 months or testing reported before the age of 3 years (n = 615), 50% had an HCV test. The majority (70% of those tested) were tested for HCV antibodies at the age of 18 months or later, although 9% had an HCV nucleic acid test at ages 2 to <6 months. No characteristics examined were found to be significantly associated with having testing reported.

Conclusions: In this surveillance report, we identify the gaps in current testing among children perinatally exposed to hepatitis C. Provider education and resources for health departments for follow-up and linkage to care can improve the identification of children requiring treatment, a vital piece of HCV elimination.

FIGURE 1

Health department follow-up and testing for HCV among children perinatally exposed to HCV.

FIGURE 2

Type and timing of HCV testing among children perinatally exposed to HCV by (A) type of test and age at first test overall (n = 314 children and 433 unique tests) and (B) timing of the first test among appropriate test results (ie, excluding NATs <2 months or antibody testing <18 months) reported from 292 children with appropriate testing. Of note, for 20 children, their first test included both a NAT and antibody test collected on the same day.