215 Risk-based screening vs universal screening for hepatitis C in pregnancy: a retrospective cohort study

Abstract

To estimate the prevalence of women who tested positive for HCV in pregnancy during periods of risk-based screening (RBS) and universal screening. To estimate the number of women who tested positive for HCV during a period of universal screening who reported risk factors (RF). This is a retrospective, single-center cohort study of 9569 women from 2/2016-12/2018 during periods of RBS & universal screening for HCV at one ObGyn Center. Study subjects were identified by initial prenatal visits performed by a physician/NP through the EMR. Chart reviews were performed to validate each pregnancy. All variables were extracted from the EMR. The reported rates of maternal HCV infection for each study period were calculated. Demographics and HCV-risk factors were reported, and differences in these variables were compared between the 2 study periods. Continuous variables were reported as mean ± standard and were tested using Student's t-test. Discrete variables were reported as N (%) and tested using Chi-square test or Fisher’s exact test for small sample sizes (n < 5). Values of p<0.05 were considered statistically significant. All analyses were carried out using R statistical software. There were 1489 patients in the RBS period; 8080 patients in the universal screening period. 17 women screened positive during RBS and 128 during universal screening (1.14% &1.58%). Demographics of HCV+ women during 2 time periods are seen in Table 2. Demographics of HCV+ women and HCV-neg women are in Table 1. The number of HCV+ women in the universal screening period that had RF for HCV was 75.8% (p=0.024).There were significantly more women who had a h/o incarceration in the universal screening period than in RBS (p=0.039). There was no statistically significant difference in the prevalence of HCV in patients during the periods of RBS and universal screening. In the current era where HCV screening is controversial, this supports risk-based screening. However, 76% of HCV+ women in the universal screening group did not report RF for HCV, which supports universal screening.View Large Image Figure ViewerDownload Hi-res image Download (PPT)