Theme: Clinical Research Year: 2021
Background: Sheway is a Vancouver-based pregnancy outreach program for parents using substances during pregnancy, many of whom are at increased risk of contracting hepatitis C (HCV) and therefore of HCV vertical transmission to their babies. We aimed to assess how many of our clinic’s parent-child dyads had been completely screened for HCV vertical transmission and to identify strategies to mitigate barriers to screening. Methods: Chart review was conducted for the parents of the babies followed by our clinic born from Jan 2018- Feb 2019. A baby was considered potentially perinatally exposed if their parent had anti-HCV antibodies in prenatal serology, addressing possible re-infection or dormancy not captured by HCVRNA. Chart was then reviewed for whether vertical transmission screening was completed at 18 months and for any identifiable barriers to screening. Lastly, a searchable screening ‘intervention’ was added to all of these babies’ electronic medical records. Results: Among the 108 parent-child dyads reviewed, 107 (99%) of parents received prenatal screening for HCV, and of this group, 30 (32%) were anti-HCV positive. At 18 months, 12 of the 30 (40%) babies had received serologic screening for vertical transmission, with no cases of vertical transmission among those screened. The biggest barrier to screening identified was the latency between birth and standard of care screening age (18 months), compounded by multiple psychosocial barriers experienced by parents. With integrating an EMR ‘intervention’ into each baby’s chart, we were able to use outreach to recall most of the unscreened babies. Conclusion: The prevalence of HCV is markedly increased in pregnant people who use drugs. To screen for HCV vertical transmission in babies, the tools in electronic medical records can be used within programs such as Sheway to identify babies at risk. Then existing wrap-around and outreach services can be used to lessen barriers for screening. Disclosure of Interest Statement: There are no conflicts of interest or commercial funding to disclose.
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