{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T10:13:51Z","timestamp":1780049631400,"version":"3.53.1"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Universal hepatitis C screening in pregnancy is not recommended by NICE due to a lack of effective interventions to prevent mother to child transmission (MTCT) and is only offered to pregnant women at increased risk of infection (intra\u2010venous drug use [IVDU] or with a HCV positive family member). No testing is offered to patients from high endemic areas. However, data regarding true seroprevalence in multi\u2010ethnic inner\u2010city populations in the UK are required. This study aimed to determine test positivity rates of HCV infection in an unselected South East London ethnically diverse population of pregnant women by universal screening during routine antenatal care compared with a \u201ctargeted\u201d screening approach. \u201cTargeted\u201d risk\u2010based screening was performed in two eras (2016, <jats:italic>n<\/jats:italic>\u00a0=\u00a01002) and subsequently in 2018, after modifying the HCV risk questionnaire (<jats:italic>n<\/jats:italic>\u00a0=\u00a01122). Universal opt out screening was similarly performed in two eras in 2017 (<jats:italic>n<\/jats:italic>\u00a0=\u00a01012) and again in 2019 (<jats:italic>n<\/jats:italic>\u00a0=\u00a01057). During screening for HBV, HIV and syphilis, anti\u2010HCV was tested, followed by an iterative HCV RNA test in those positive for anti\u2010HCV. All anti\u2010HCV\u2010positive women were referred to the specialist hepatology service, and testing was offered to all family members. All HCV RNA\u2010positive patients were followed during pregnancy and post\u2010delivery period and were offered treatment. All infants of HCV RNA\u2010positive mothers were linked to care with paediatric team. In the 2016 \u201ctargeted\u201d screening cohort 212\/1002 had a risk of BBV (blood borne viral) infection and (0.6%) were anti\u2010HCV positive and HCV RNA positive. 0.3% patients were newly diagnosed. In the 2017 universal screening cohort, 1012\/1038 pregnant women consented to testing. 0.96% were anti\u2010HCV positive and 0.86% women were HCV RNA positive with 0.67% newly diagnosed. After modification of the risk\u2010based questionnaire, a second risk\u2010based targeted cohort were tested in 2018: 342\/1122 (31%) were assessed as at risk and were offered an anti\u2010HCV test. 0.71% were anti\u2010HCV positive and 0.27% were HCV RNA positive. In the 2019 cohort tested by universal screening, 1049\/1057 women were tested and 0.85% tested positive for anti\u2010HCV, 0.28% women were HCV RNA positive. All newly diagnosed patients were born abroad. All patients had mild liver disease and had normal pregnancies. All patients were treated post\u2010delivery and achieved SVR. All patients were negative for other BBV infections. In conclusion, the anti\u2010HCV test positive rate in this ethnically diverse pregnant cohort ranged between 0.96% and 0.6% (whole cohort) but the rate depended upon the era and screening methodology used. Universal screening detected a higher numbers of anti\u2010HCV positive women during pregnancy, including those not previously aware of their hepatitis C. While there was not significant drop in seroprevalence in pregnant women between 2016 and 2019, we observed that the ratio of HCV RNA positive to anti\u2010HCV positive women has declined over time, from 0.86% in 2016 (100% HCV RNA+) to 0.28% in 2019 (33% HCV RNA+) for whole cohort probably due to increased HCV treatment rates from 2016. These data have important implications for hepatitis C testing in pregnancy and the appropriate methodology to use for maximal accuracy.<\/jats:p>","DOI":"10.1111\/jvh.13752","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T04:25:45Z","timestamp":1663907145000},"page":"1079-1088","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Universal versus targeted screening for <scp>HCV<\/scp> infection in pregnancy in a diverse, multi\u2010ethnic population: Universal screening is more comprehensive"],"prefix":"10.1111","volume":"29","author":[{"given":"Ivana","family":"Carey","sequence":"first","affiliation":[{"name":"Institute of Liver Studies King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moigboi","family":"Christiana","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"McLeod","family":"Marie\u2010Ange","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bowyer","family":"Teresa","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guerra Veloz","family":"Maria","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9579-4469","authenticated-orcid":false,"given":"Geoff","family":"Dusheiko","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4754-828X","authenticated-orcid":false,"given":"Kosh","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80369-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27259"},{"key":"e_1_2_8_4_1","volume-title":"Global Health Sector Strategy on Viral Hepatitis 2016 to 2021: Towards Ending Hepatitis","author":"WHO","year":"2016"},{"key":"e_1_2_8_5_1","volume-title":"Global Hepatitis Report 2017","author":"WHO","year":"2017"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15201"},{"issue":"3","key":"e_1_2_8_7_1","first-page":"B8","article-title":"Society for Maternal\u2010Fetal Medicine Consult Series #56: Hepatitis C in pregnancy\u2010updated guidelines: Replaces consult number 43, November 2017","volume":"225","author":"Society for Maternal\u2010Fetal Medicine (SMFM)","year":"2021","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30791"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu447"},{"key":"e_1_2_8_10_1","first-page":"e191","article-title":"Global prevalence of hepatitis C virus in women of childbearing age in 2019: a modelling study","volume":"8","author":"Dugan E","year":"2020","journal-title":"Lancet Glob Health"},{"key":"e_1_2_8_11_1","unstructured":"UK Health Security Agency.Hepatitis C in England 2022 Working to Eliminate Hepatitis C as a Public Health Problem. Accessed April 4 2022.https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/1057262\/HCV\u2010in\u2010England\u20102022\u2010short\u2010report.pdf"},{"key":"e_1_2_8_12_1","unstructured":"UK National Screening Committee.Screening for hepatitis C in pregnancy screening recommendation.Public Health England;2018."},{"key":"e_1_2_8_13_1","unstructured":"NHS Infectious disease in pregnancy programme.Public Health England;2016."},{"key":"e_1_2_8_14_1","first-page":"538","article-title":"Vertical hepatitis C virus transmission","volume":"6","author":"Tosone G","year":"2014","journal-title":"World J of Gastroenterology"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00088.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02681-7"},{"key":"e_1_2_8_17_1","first-page":"123","article-title":"Maternal risk factors associated with inadequate testing and loss to follow\u2010up infants with perinatal hepatitis C virus exposure","volume":"14","author":"Bhadawaj AM","year":"2020","journal-title":"J Neonatal Perinatal Med"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.47.2.277"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.015"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010661"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz063"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.08.080"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1282"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(20)30373-3"}],"container-title":["Journal of Viral Hepatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.13752","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jvh.13752","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.13752","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T03:01:02Z","timestamp":1692586862000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jvh.13752"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,30]]},"references-count":23,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1111\/jvh.13752"],"URL":"https:\/\/doi.org\/10.1111\/jvh.13752","archive":["Portico"],"relation":{},"ISSN":["1352-0504","1365-2893"],"issn-type":[{"value":"1352-0504","type":"print"},{"value":"1365-2893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,30]]},"assertion":[{"value":"2022-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}