The following is a summary of “Integrated prenatal and hepatitis c virus care increases linkage,” published in the FEBRUARY 2023 issue of Obstetrics and Gynecology by Chappell C, et al.
Although universal hepatitis C virus (HCV) testing is advised for pregnant patients, there is little connection between HCV care and postpartum HCV treatment. Therefore, for a retrospective cohort study, researchers sought to assess the impact of an innovative healthcare delivery model for pregnant patients with active HCV infection on engagement with HCV treatment.
All pregnant patients who received prenatal treatment at our facility between July 1, 2020, and June 30, 2021, were the subjects of a retrospective cohort study. Our intervention was a cutting-edge approach to healthcare delivery that was put into place in June 2020. It included two components: an electronic medical record (EMR) Best Practice Alert (BPA) to remind healthcare professionals of the importance of HCV testing at the first prenatal appointment and reflex testing for HCV RNA if IgG positive; and a perinatal HCV clinic to offer antenatal HCV consultation as well as postpartum care. The outcomes assessed included rates of HCV testing, prevalence, consultation attendance, and therapy.
During the study period, 1,307 pregnant patients received prenatal care, and 1,087 (83%) were screened for HCV. Of those screened, 57 were HCV antibody positive (4.4%), and 24 (1.84%) had an active HCV infection. Of the 24 patients with active HCV infection, 15 (62.5%) attended the perinatal HCV clinic, but only 3 (12.5%) received HCV treatment. Two of these patients received treatment through a study of antenatal HCV treatment, and one received postpartum treatment.
Increased HCV screening and referral to a perinatal HCV clinic improved engagement with HCV care. However, additional interventions were needed to improve postpartum treatment uptake.
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