Reliability of risk-based screening for hepatitis C virus infection among pregnant women in Egypt

El-Kamary, Samer S.; Hashem, Mohamed; Saleh, Doa’a A.; Ehab, Mohamed; Sharaf, Sahar A.; El‐Mougy, Fatma; Abdelsalam, Lobna; Jhaveri, Ravi; A.L.Aboul-Nasr,; Elghazaly, Hesham

doi:10.1016/j.jinf.2015.01.009

Cited by 28 publications

(28 citation statements)

References 29 publications

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“…This study has demonstrated that costeffectiveness improves when the prevalence of HCV is increased assuming that costs and treatment uptake are comparable to those observed in this study. In countries, such as Egypt where antenatal HCV prevalence have been reported at up to 2.4% [36], the benefits of screening would potentially outweigh the additional cost incurred if the same assumptions were made. Improved cost-effectiveness estimated in younger patients further highlights the importance of early detection.…”

Section: Discussionmentioning

confidence: 99%

Is antenatal screening for hepatitis C virus cost-effective? A decade’s experience at a London centre

Selvapatt

Ward

Bailey

et al. 2015

Journal of Hepatology

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Section: Discussionmentioning

confidence: 99%

Is antenatal screening for hepatitis C virus cost-effective? A decade’s experience at a London centre

Selvapatt

Ward

Bailey

et al. 2015

Journal of Hepatology

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“…Many of these studies, in both the United States and abroad, had identified subsets of women who tested positive for HCV without any known risk factors. 26,29,41,[43][44][45] In one study, conducted in Maryland, 10% of HCVþ pregnancies occurred in women with no reported risk factor. 41 In Ireland, a country whose screening guidelines correlate with the guidelines in the United States, a study found 27% of HCVþ females had no known risk factors.…”

Section: Risk-based Versus Universal Screeningmentioning

confidence: 99%

Hepatitis C Virus in Pregnancy: A Systematic Review of the Literature

et al. 2020

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Objective The aim of this study was to systematically review the literature to summarize recent demographic characteristics of hepatitis C virus (HCV) infection during pregnancy and the efficacy of risk-based versus universal screening. Study Design PubMed, EMBASE, and Cochrane Library were searched to identify relevant studies. Studies that recognized hepatitis C as a primary or secondary outcome, with pregnant women as the population and written in English, were included. Studies were excluded if they were abstracts only, written in foreign language, or published prior to 1992. Two researchers independently screened all the studies by titles, abstracts, and full text. Conflicts were settled by a third researcher. Results A total of 698 studies were identified with 78 fitting inclusion criteria. In total, 69 epidemiologic and 9 comparison studies were found. Identified risk factors for HCV infection include intravenous or illicit drug use, sexually transmitted coinfection, high-risk behaviors in the partners, high parity, and history of miscarriages or abortions. Demographic characteristics associated with HCV include non-Hispanic white race, American Indian or Alaskan Native ethnicity, and increasing age. Providers may fail to adequately screen for each risk factor, and up to two-thirds of women with a known risk factor are not screened under current guidelines. Finally, up to 27% of HCV+ women have no identifiable risk factors for infection. Conclusion There is evidence that risk-based screening fails to identify a large proportion of HCV positive women in pregnancy and that pregnant women with HCV risk factors and consistent with current screening guidelines fail to be tested. We urge for the adoption of universal screening to identify these women and offer treatment.

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“…Risk-based screening, however, remains intrinsically limited, in part due to inconsistent assessment of risk factors, inaccurate reporting, or HCV positivity in women with no reported risk factors. (57,58) Conversely, universal screening for HCV has been shown to be cost-effective in all treatment eligibility scenarios and US prevalence rates, estimating that universal screening of pregnant women would result in the identification of 33,000 HCV-positive women in 2018 alone. (59) Given the increasing burden of disease in this population, there is increasing interest in treatment in pregnancy, with the simultaneous goals of interrupting vertical transmission and achieving cure with a majority of HCV-positive women interested in treatment during pregnancy, to prevent mother-to-child transmission.…”

Section: Future Directions and Needs For Researchmentioning

confidence: 99%