Prevalence and factors associated with hepatitis C among pregnant women in China: a cross-sectional study


Hepatitis C virus infection can lead to cirrhosis, liver failure, and hepatocellular carcinoma, and is transmitted from mother to child.13Therefore, investigating the prevalence of HCV infection in pregnant women is of great importance. Routine HCV screening during pregnancy is currently not widely recommended due to cost-effectiveness reasons and evidence of voluntary clearance in Japan, Canada, China, and other countries.14,15,16The results we analyzed showed that the HCV prenatal screening rate in pregnancy was 90.20%, lower than the rate of hepatitis B virus, HIV, and syphilis in pregnancy in China.17,18,19.

In this study, the prevalence of HCV antibodies in pregnant women was 0.11% (95% CI 0.09%–0.13%), which is similar to that reported in local studies. For example, according to survey data from Zhongshan City, Guangdong Province, the proportion of pregnant women infected with HCV gradually decreased from her 2009 to her 2019, and her HCV positive rate in 2018 was 0.25%, while her 2019 The year was 0.00% of her.20A meta-analysis by Ma et al. From 2008 to 2018, her hepatitis C antibody prevalence among Chinese pregnant women was 0.235% (95% CI 0.189%–0.286%)twenty oneThe prevalence of HCV in the Chinese general population is 0.38% (95% CI 0.23%–0.53%).twenty two, which is higher than that found in pregnant women. Compared to other counties, the percentage appears to be closer to developed countries, but lower than lower middle income countries.The reported prevalence of maternal hepatitis C virus infection in the United States was 0.24% in 2020, but the rate was much higher in Africatwenty three (3.4%), Pakistantwenty four (2.22%) and Egypttwenty five (6.1%).

It is worth noting to identify sociodemographic characteristics associated with an increased risk of HCV infection.In the present study, older age was found to be an important factor in HCV positivity (Cochrane-Armitage test). Z.= 3.41, P.= 0.0006). Similarly, Camis et al.twenty five and Costa et al.26 Older age has been found to be one of the most important risk factors for HCV infection in pregnant women. However, Dagnew et al.27 reported higher HCV prevalence among young pregnant women due to the fact that young women are more likely to be sexually active and exposed to multiple sexes. Our findings also showed that region and occupation are important factors in HCV transmission. This may be attributed to geographic location, differences in various socioeconomic status, and lack of awareness of her HCV infection in specific areas.

Analysis of pregnancy complications and adverse neonatal effects associated with HCV infection during pregnancy can be complicated by the difficulty in discerning whether infection is a direct effect or a potential confounding factor. there is. Nevertheless, we confirmed that HCV infection was found to be one of the risk factors for ICP during pregnancy. this is,28,29,30 Its ICP was more common in patients with chronic HCV infection, including pregnant women. Moreover, although no association between gestational diabetes and HCV infection was observed in our study, Samir Rouabhia et al.31 HCV was thought to exacerbate insulin resistance or diabetes, reduce the ability to fight infection, and increase the risk of type 2 diabetes in HCV-infected pregnant women. We also found an association between placenta previa and HCV infection, but HCV infection did not affect the development of placenta previa. Similarly, Pifer et al.32 No significance was seen for eclampsia, premature rupture of membranes, and placenta previa.reported33,34 Adverse neonatal outcomes such as preterm birth and low birth weight (LBW) are likely to occur in mothers with HCV, but such findings were not replicated in the present study.

Interesting, despite evidence of co-infection with sexually transmitted infections.34,35,36,37 Although similar transmission methods and similar pathological mechanisms allow the prevalence of HCV to be aggregated, such associations were not significant in the present study with respect to HBV coinfection, and cases of HCV and HIV coinfection were not significant. There was no Syphilis co-infection was identified as a risk factor from data analysis, but the rates of HBV and syphilis co-infection in HCV-infected participants were 4.86% and 7.64%, respectively.Co-infection rates differed from those reported in the extant literature38,39The reported HBV rate in HCV-infected hemodialyzers was 5.7%, the HIV rate in pregnant women was 3.9%, and the syphilis rate in unpaid blood donors was 0.5%. A possible reason for this discrepancy is that most of the participants are from urban areas and may have higher levels of education, health awareness and economic status. From a clinic point of view, pregnant women who are co-infected with sexually transmitted infections should be managed and taken seriously. A combination of screening and follow-up monitoring should be considered.

There were some limitations to be aware of. First, due to time and funding limitations, data were collected only from her three provinces or cities, so the findings may not be generalized across pregnant women in China. Furthermore, the present study is of a cross-cutting nature and cannot reflect casual relationships. On the other hand, there were duplicates (2950) and cases without her HCV test results (15,297) during data collection. Indeed, HCV prenatal screening helps inform HCV prevalence and hepatitis C virus status in pregnant women, facilitating timely clinical identification and management of key maternal outcomes. Further studies on cost-effectiveness and disease burden are needed to determine whether universal screening for HCV in clinics is recommended.

Findings from current and past research14 We show that HCV testing based on the presence of risk factors may be justified in pregnant women not only in obstetrics, but also in obstetric clinics. It should also be designed to educate and promote HCV prevention and health care knowledge in communities, hospitals, schools, etc. In addition, based on the data support of this study, a longitudinal study of a pregnant woman on her HCV infection should be conducted to understand the mechanism. Elucidation of mother-to-child transmission, consideration of prevention of HCV neonatal infection, and elucidation of risk factors for HCV infection. Achieving her WHO goal of eradicating HCV will require effort and support from all sectors of society.



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