SCREENING FOR HEPATITIS C VIRUS (HCV) INFECTION AMONG PREGNANT WOMEN IN A LARGE CITY HOSPITAL: AN EVALUATION OF PERFORMANCE

M Boucher, N Lapointe, J Samson
Ste-Justine Hospital, Centre Maternel et Infantile sur le SIDA, University of Montreal, Montreal, Quebec

In Canada, universal screening for HCV among pregnant women is not recommended although targeted screening should be offered to all women with risk factors.
Objectives: To ascertain the current practice in HCV screening among pregnant women in Ste-Justine Hospital, a major referral Centre in the province of Quebec for high risk pregnancies as well as for HIV and other infectious diseases. To document, in a pilot study, the prevalence of HCV infection among a subgroup of HIV-infected pregnant women currently followed at Ste-Justine hospital.
Method: From March to May 2000, 1 013 women delivered at Ste-Justine Hospital. All charts were reviewed and the number of HCV tests done was documented. To determine HCV prevalence in HIV-infected mother and child cohort at the Centre Maternel et Infantile sur le SIDA, a looked back was done on 150 samples from HIV-infected women.
Results: During the study period, HCV serology was performed only on 26/1013 (2,6%) pregnant women and 2/26 were HCV-infected. 9 HIV-infected pregnant women were followed, HCV testing was done in 7 women and none were co-infected. The results of the pilot study indicates that the general prevalence of HCV infection in our HIV cohort is currently 20,6% (31/150). More than 70% of HCV-infected women were recruited during the last 5 years. Among 133 mother and child pairs 25 (25/133: 18.8%) mothers were HCV/HIV co-infected and gave birth to 31 children: 5 children were HCV-infected (5/31: 16.1%), only one infant is HIV/HCV co-infected.
Conclusion: HCV infection is prevalent among pregnant women especially in the context of HIV infection. Our poor performance to screen for HCV based on risk factors should be an incentive to rethink our screening approach. The next question to ask is: shouldn’t every pregnant woman be screened for HCV?