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PTU-100 Should we screen the antenatal population for hepatitis C in the UK? a snapshot of seroprevalence from a single london centre
  1. E Dannhorn1,
  2. R Davis2,
  3. C Koshy2,
  4. P Kooner3
  1. 1Hepatology
  2. 2Department of Microbiology, BHRUT
  3. 3Hepatology, Royal London Hospital, London, UK

Abstract

Introduction The paradigm of hepatitis C (HCV) treatment has shifted, with the introduction of revolutionary regimens offering sustained virological response rates of >90%. However, only 3% of HCV patients receive treatment each year, and 50% with chronic HCV are undiagnosed.1

There are significant differences in HCV prevalence within minority groups. Infection rates in South Asian and Eastern European groups are as high as 2.7%2and 5.1%, respectively.3The area served by Barking, Havering and Redbridge NHS Trust (BHRUT) reflects huge population ethnic diversity.

Screening at antenatal (AN) booking allows testing of women not included in current guidelines. Data for AN populations has not been determined. We postulated that AN testing for HCV antibody (HCV Ab) would identify significant seroprevalence.

Method 1000 sequential AN samples, each representing serum collected from one women at AN booking, were anonymously tested for anti-HCV Ab, hepatitis B surface antigen (HBsAg), and HIV, using ARCHITECT (Abbott).

Positive results were confirmed with VIDAS (bioMérieux). Equivocal results were ARCHITECT positive/VIDAS negative.

Conclusion Our results demonstrate a snapshot of the seroprevalence of HCV, HBV and HIV in the AN population served by BHRUT. HCV prevalence was in keeping with national statistics. AN HBsAg and HIV Ab positivity was higher than national data.4

Limitations include small sample size, reflecting 1 month of AN samples collected. Serum was only tested for HCV Ab; viraemia should be confirmed by PCR. Anonymous testing prevented identification of known cases.

We argue that AN testing represents opportunity for early diagnosis. AN testing for HBV and HIV were introduced as diagnosis allowed early treatment, which can now be provided for HCV. It is interesting that prevalence within our AN cohort is similar to that of the general population. AN populations represent well patients, motivated to engage with health care, with high uptake of screening. HCV testing can be added safely and reliably to existing panels. With the revolution in HCV treatment, there must now be an emphasis placed on early identification.

Disclosure of interest E. Dannhorn Grant/ Research Support from: Research support granted by Abbott, R. Davis: None Declared, C. Koshy: None Declared, P. Kooner: None Declared.

References

  1. Public Health Englang (PHE). HCV in the UK: 2013 report

  2. Uddin, et al . Prevalence of chronic viral hepatitis in people of south Asian ethnicity living in England: the prevalence cannot necessarily be predicted from the prevalence in the country of origin. J Viral Hepat. 2010;17(5):327–35

  3. PHE; HCV in the UK: 2014

  4. PHE; Annual report from the sentinel surveillance study of blood borne virus testing in England: data for Jan-Dec 2013

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