707 Hepatitis C screening in a high risk obstetric population

Abstract

The Society of Maternal-Fetal Medicine recommends screening for risk factors for Hepatitis C (HCV) in pregnancy. HCV testing is indicated for patients with identifiable risk factors. The objective of our study was to evaluate the adequacy of this testing methodology in a high risk patient population. This was a retrospective cohort study of 739 patients delivered at a tertiary care center from 2018-2019. The rate of HCV screening was determined by medical chart review for risk factors at initial prenatal visit: history of injected/intranasal drug use, long-term hemodialysis, percutaneous/parenteral exposures in an unregulated setting, blood transfusion/organ transplantation prior to 1992, incarceration, or sexually transmitted disease (STD). Patient charts were also evaluated for clinical risk factors: STD in pregnancy, elevated ALT level, and unexplained chronic liver disease. Analysis was performed to determine if those with identified risk factors were appropriately tested for HCV. All patients in the study were screened for at least one HCV risk factor, though none were fully screened for all of the above risk factors. The most frequently screened risk factors were: history of STD (n=726, 98.2%) and history of injected/intranasal drug use (n=715, 96.8%). The least frequently screened were: history of percutaneous/parenteral exposures (n=1, 0.1%) and history of incarceration (n=4, 0.5%). Overall, 327 (44.2%) of patients screened positive for risk factors, however only 9 (1.2%) were subsequently tested for HCV. Our study demonstrates that an insufficient number of pregnant women with identified risk factors were appropriately tested for HCV disease. More research is needed to determine if universal HCV screening during pregnancy should be considered.