Abstract：
OBJECTIVE: Children perinatally exposed to hepatitis C virus (HCV) should be screened for infection, yet testing rates are low. Clinical perinatal HCV testing recommendations vary and may contribute to poor completion. This study examines pediatric care factors associated with perinatal HCV testing completion.
METHODS: A cohort of people living with HCV in Philadelphia, Pennsylvania, who delivered a live birth in 2016 to 2020 and their children were followed by the Philadelphia Department of Public Health. The association of completion of HCV screening with pregnant/postpartum person demographics, pediatric care factors, and testing policy were retrospectively explored. χ2 and multivariable logistic regressions were used.
RESULTS: HCV-positive pregnant people gave birth to 457 children of whom 307 (67.2%) were tested for HCV according to recommendations and 79 (17.2%) were inadequately tested. Children were more likely to be tested if born to a pregnant person with HIV coinfection (P = .007), if they were always on schedule for vaccinations (P < .001), and if they attended the 18-month well visit (P < .001). Completion rates varied significantly by pediatrician\'s testing policy: 90.9% tested if the policy was for 2 months, 79.6% if 2 to 12 months, 61.9% if 12 months, and 58.5% if 18 months of age (P < .001).
CONCLUSIONS: Timing of perinatal HCV testing policies was significantly associated with testing completion rates. Testing at 2 months was associated with far better HCV testing completion than other strategies, regardless of birthing person and pediatrician factors. These findings suggest routine HCV testing of children perinatally exposed to HCV is best achieved in the first year of life.
OBJECTIVE: Children perinatally exposed to hepatitis C virus (HCV) should be screened for infection, yet testing rates are low. Clinical perinatal HCV testing recommendations vary and may contribute to poor completion. This study examines pediatric care factors associated with perinatal HCV testing completion.
METHODS: A cohort of people living with HCV in Philadelphia, Pennsylvania, who delivered a live birth in 2016 to 2020 and their children were followed by the Philadelphia Department of Public Health. The association of completion of HCV screening with pregnant/postpartum person demographics, pediatric care factors, and testing policy were retrospectively explored. χ2 and multivariable logistic regressions were used.
RESULTS: HCV-positive pregnant people gave birth to 457 children of whom 307 (67.2%) were tested for HCV according to recommendations and 79 (17.2%) were inadequately tested. Children were more likely to be tested if born to a pregnant person with HIV coinfection (P = .007), if they were always on schedule for vaccinations (P < .001), and if they attended the 18-month well visit (P < .001). Completion rates varied significantly by pediatrician\'s testing policy: 90.9% tested if the policy was for 2 months, 79.6% if 2 to 12 months, 61.9% if 12 months, and 58.5% if 18 months of age (P < .001).
CONCLUSIONS: Timing of perinatal HCV testing policies was significantly associated with testing completion rates. Testing at 2 months was associated with far better HCV testing completion than other strategies, regardless of birthing person and pediatrician factors. These findings suggest routine HCV testing of children perinatally exposed to HCV is best achieved in the first year of life.
摘要：
■围产期接触丙型肝炎病毒（HCV）的儿童应进行感染筛查，然而测试率很低。临床围产期HCV检测建议各不相同，可能导致完成不良。这项研究调查了与围产期HCV检测完成相关的儿科护理因素。
■费城的一群HCV感染者，宾夕法尼亚,他们在2016年至2020年分娩了活产，费城公共卫生部紧随其后。完成HCV筛查与孕妇/产后人口统计学的关联，儿科护理因素，和测试政策进行了回顾性探索。使用χ2和多变量逻辑回归。
HCV阳性孕妇生了457名儿童，其中307名（67.2％）根据建议进行了HCV检测，79名（17.2％）未进行充分检测。如果孕妇同时感染艾滋病毒，儿童更有可能接受检测（P=0.007），如果他们总是按时接种疫苗(P<.001)，以及他们是否参加了为期18个月的良好访问（P<.001）。根据儿科医生的测试政策，完成率差异很大：如果政策持续2个月，则测试90.9%，如果2至12个月，则为79.6%，61.9%，如果12个月，如果年龄为18个月，则为58.5%(P<.001)。
■围产期HCV检测政策的时机与检测完成率显著相关。与其他策略相比，2个月的测试与更好的HCV测试完成相关，不管出生的人和儿科医生的因素。这些发现表明，围产期暴露于HCV的儿童的常规HCV检测最好在出生后的第一年实现。
■围产期接触丙型肝炎病毒（HCV）的儿童应进行感染筛查，然而测试率很低。临床围产期HCV检测建议各不相同，可能导致完成不良。这项研究调查了与围产期HCV检测完成相关的儿科护理因素。
■费城的一群HCV感染者，宾夕法尼亚,他们在2016年至2020年分娩了活产，费城公共卫生部紧随其后。完成HCV筛查与孕妇/产后人口统计学的关联，儿科护理因素，和测试政策进行了回顾性探索。使用χ2和多变量逻辑回归。
HCV阳性孕妇生了457名儿童，其中307名（67.2％）根据建议进行了HCV检测，79名（17.2％）未进行充分检测。如果孕妇同时感染艾滋病毒，儿童更有可能接受检测（P=0.007），如果他们总是按时接种疫苗(P<.001)，以及他们是否参加了为期18个月的良好访问（P<.001）。根据儿科医生的测试政策，完成率差异很大：如果政策持续2个月，则测试90.9%，如果2至12个月，则为79.6%，61.9%，如果12个月，如果年龄为18个月，则为58.5%(P<.001)。
■围产期HCV检测政策的时机与检测完成率显著相关。与其他策略相比，2个月的测试与更好的HCV测试完成相关，不管出生的人和儿科医生的因素。这些发现表明，围产期暴露于HCV的儿童的常规HCV检测最好在出生后的第一年实现。
