Hepatitis C Vertical Transmission (Laboratory Testing in Mothers and Neonates)

Abstract

Background: Infection with the hepatitis C virus (HCV) affects 2%-3% of the world’s population. Egypt has the highest recorded prevalence of HCV in the world, reaching 14.7% for HCV-antibody (Ab) positivity among 15- to 59-year-olds in 2008. The natural history of vertically acquired HCV in children is uncertain, with the majority (73–92%) suffer continual infectious state but stay asymptomatic in the first few years. Aim: To investigate the diagnostic performance and characteristics of maternal HCV RNA testing in predictability of developing neonatal positive HCV Ab and positive HCV RNA. Methodology: At Benha University hospital from 2016 to 2018 Obstetrics and Gynecology department in collaboration with Hepatology, Gastroenterology and infectious disease department, HCV RNA +ve pregnant women were recruited into a cohort study from gestation to 6 months after delivery. Maternal and child research data were collected via HCV antibody testing and HCV RNA testing. Results: Maternal HCV RNA had statistically significant low diagnostic performance and characteristics in prediction of developing neonatal positive HCV Ab (AUC = 0.749, SE = 0.050, Pvalue < 0.001, 95% CI = 0.651 – 0.847 , cutoff ≥ 4.7, sensitivity = 0.839, specificity = 0.614) and positive HCV RNA (AUC = 0.787, SE = 0.080, P value = 0.007, 95% CI = 0.629 – 0.944, cutoff ≥ 9.2 sensitivity = 0.625, specificity = 0.870). Conclusions: Possibly, there is inadequate or incomplete screening of vulnerable due to, low maternal health-care compliance. Complete testing of all neonates at risk of vertically acquired HCV requires to be noted in medical recording system as early management intervention could influence disease course.