Prevalence of hepatitis C infection in pregnant women in South Australia

Objectives: To estimate the prevalence of hepatitis C virus (HCV) seropositivity and known risk factors for HCV infection in a group of pregnant women. Design: Cross-sectional survey. Setting: Lyell McEwin Health Service, Elizabeth, South Australia (a general public hospital with an annual average of about 2000 deliveries). Subjects: 1537 consecutive women who delivered at the Lyell McEwin Health Service from February 1995 to December 1995. Outcome measures: Presence of HCV antibodies; and associations between HCV-antibody status and known risk factors. Results: 17 women (1.1%) were HCV-seropositive. Risk factors significantly more prevalent among HCV-seropositive patients were: a history of injecting drug use, a past or present sexual partner who had injected drugs, having a tattoo and having been incarcerated. The proportions who had received a blood transfusion, had acquired a sexually transmitted disease or were positive for hepatitis B virus surface antigen were not significantly different between seropositive and seronegative women. Multivariate analysis showed that only injecting drug use remained a strong independent predictor of HCV-seropositivity (odds ratio [OR], 50.1; P < 0.001), while having a tattoo approached significance (OR, 3.5; P = 0.07). Conclusion: As only 1.1% of this sample of women were HCV-seropositive, screening of all pregnant women does not seem warranted. Testing on the basis of a history of risk factors, such as injecting drug use and having a tattoo, would detect undiagnosed HCV infections more efficiently.