Author information
1
Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
2
Drug Health Services, Sydney Local Health District, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
3
Discipline of Addiction Medicine, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
4
Liver Immunobiology Group, Centenary Institute, Royal Prince Alfred Hospital and University of Sydney, Sydney, New South Wales, Australia.
5
Department of Women and Babies, Sydney Local Health District, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
6
Discipline of Obstetrics, Gynaecology and Neonatology, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Abstract
AIM:
To investigate hepatitis C virus (HCV) testing patterns and engagement with health care for women positive for HCV antibodies (anti-HCV) in pregnancy and their children through pregnancy and the first 2 years of the child's life.
METHODS:
At a large inner-city Australian hospital from 2010 to 2012, anti-HCV positive pregnant women were recruited into a cohort study from pregnancy to 2 years post-delivery. Maternal and child data were collected by questionnaire and medical record extraction.
RESULTS:
During the study 29 women participants delivered 31 children. HCV RNA was detected in 64% (18/28) of pregnancies, with injecting drug use, the most likely route of maternal infection. Relatively high maternal health-care engagement during pregnancy reduced after delivery. There was evidence of ongoing illicit drug use in the majority of women. Of the children, 58% (18/31) had some HCV testing confirmed but complete testing was confirmed for only 10% (3/31). Largely, testing was incomplete or unknown. No vertical transmission was identified. Forty-two percent (13/31) of children were placed in out-of-home-care.
CONCLUSIONS:
Potentially, there is a high risk of inadequate or incomplete HCV testing of vulnerable children. Ongoing maternal drug use, poor maternal health-care engagement and placement in out-of-home-care may increase the risk. Complete testing of all children at risk of vertically acquired HCV needs to be ensured.