A RECENT study conducted at the Philadelphia Department of Public Health, Pennsylvania, USA, has underscored the critical need for early hepatitis C virus (HCV) screening in children born to HCV-positive mothers. The research, focusing on births from 2016–2020, revealed that adherence to testing recommendations is alarmingly low, prompting a call for standardised testing protocols.
The study tracked a cohort of HCV-positive pregnant individuals in Philadelphia and their children, and the researchers examined the factors associated with successful HCV testing, including demographics, perinatal hepatitis C testing policy followed by the paediatrician, and paediatric care markers. χ2 and multivariable logistic regressions were used.
Out of 457 children born to HCV-positive mothers, only 307 (67.2%) were tested according to medical recommendations, while 79 children (17.2%) received inadequate testing. Several key factors were identified as influencing testing rates. Children born to mothers with HCV and HIV coinfection were more likely to be tested (P=0.007). Additionally, adherence to vaccination schedules (P<0.001) and attendance at the 18-month well-child visit (P<0.001) were strongly associated with higher testing rates.
A significant finding from the study was the impact of paediatric testing policies on completion rates. Children tested at 2 months of age had the highest completion rate at 90.9%. In contrast, those tested between 2–12 months, at 12 months, and at 18 months had progressively lower rates of 79.6%, 61.9%, and 58.5%, respectively (P<0.001).
The study suggests that early testing, specifically around the 2-month mark, leads to significantly higher completion rates, regardless of other demographic or healthcare factors. These findings are in line with the Centers for Disease Control and Prevention (CDC)’s 2023 recommendation to test with HCV RNA between 2–6 months of age. Standardised, early HCV testing protocols could vastly improve the rates of diagnosis and subsequent care for children exposed to HCV perinatally.
Ada Enesco, EMJ
Reference
Kuncio DE et al. Factors associated with perinatal hepatitis C screening among exposed children: 2016–2020. Pediatrics. 2024; 154(1):e2023064745.
