Prospective cohort study of children exposed to hepatitis C virus through a pregnancy screening program

AbstractObjectives Porto Alegre, in south Brazil, has one of the highest hepatitis C virus (HCV) infection rates country (84.4 cases/100 000 2018). Prenatal screening HCV, however, not been routinely offered. Methods A longitudinal study pregnant women with HCV and their infants was conducted between January 2014 December 2018. Screening for antibodies offered to all delivering at tertiary institution. RT-PCR performed if woman seropositive. Infants were followed prospectively. Results Among 18 953 during period, 17 810 screened (93.9%) 130 positive results (HCV seroprevalence 0.7%). HCV-RNA detectable 57/117 cases (48.7%). viremia associated use injectable drugs (P = 0.03), inhaled/crack drug 0.02), having an HCV-seropositive partner, ≥3 lifetime sexual partners < 0.01). Genotype 1 most prevalent (68%) pregnancy. 43 children follow-up, six (13%) HCV-infected (transmission rate 13.9%); 50% infected genotype 3. Two (33%) cleared infection; mothers had genetic polymorphisms clearance. Conclusion vertical transmission high population, pregnancy being vastly underdiagnosed. Public health efforts must focus on this vulnerable population disease prevention early treatment.