A retrospective chart review of Hepatitis C prevalence and screening practices in pregnancy

Abstract

Hepatitis C is a significant cause of morbidity and mortality. The CDC estimates that 2.7-3.9 million people in the US have chronic hepatitis C. Serious consequences of hepatitis C infection include cirrhosis, liver cancer and death. Hepatitis C is transmitted through intravenous drug use, sex, and through birth to an infant by an infected mother. Due to high rates of intravenous drug use, Baltimore has particularly high rates of hepatitis C infection. The Maryland Department of Health and Mental Hygiene estimates that in 2014, 26-40,000 individuals in Baltimore had Hepatitis C infection. However this is likely an underestimate due to the fact that many individuals carry asymptomatic infections and may not seek medical attention. A cure is available for hepatitis C, however individuals need to know they are infected in order to be treated. Pregnancy is a time when women have multiple regular encounters with healthcare providers. This unique period of access has been used with great success to screen and treat women for HIV infection, virtually eliminating perinatal transmission of HIV and connecting many women and their partners to treatment. A similar approach may prove useful for Hepatitis C. However, first it will be necessary to determine the frequency with which women are screened and tested under current guidelines. The purpose of this study is to determine the prevalence of known hepatitis C infection in the pregnant population of a major Baltimore City hospital and the frequency with which women are being tested for hepatitis C under current guidelines.