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HCV Prevalence Almost 2% in New Mothers in 2 New York State Regions
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CROI 2020, March 8-11, 2020, Boston
Mark Mascolini
Almost 2% of women who recently gave birth in central and western New York State had antibody evidence of HCV infection, according to a study using the Luminex assay on dried blood spots collected from newborns [1]. HCV prevalence in new mothers across the state stood at about 0.8%.
Researchers from the New York State Department of Health and other centers reported a statewide shift in HCV prevalence toward younger age groups and women. Women with active HCV infection (denoted by HCV RNA positivity) can transmit HCV to their babies. Health authorities estimate that 6% of women with active HCV will pass the hepatitis virus to their infants. That rate jumps to 11% in women coinfected with HIV.
The study used a newly developed Luminex assay to test newborn dried blood spots for HCV antibodies, which infants passively acquire from mothers. From women whose infants gave dried blood spot samples, researchers collected deidentified data including county of residence, birth weight, and gestational age. To read dried blood spots, workers had developed a high-throughput, low-cost HCV immunoassay and validated it for accuracy, sensitivity, and specificity. To identify HCV antibody-positive samples, researchers used a conservative cutoff and duplicate retests.
The analysis began with 28,439 dried blood spots collected within 6 weeks of birth from New York State residents. Of those, 25,571 were unique samples from individual babies, of which 18,581 got tested by Luminex. Among tested samples, 148 (0.8%) were HCV antibody-reactive. Of 2868 repeat samples, 41 of 1654 tested by Luminex (2.5%) were HCV antibody-reactive.
HCV prevalence rates proved highest in two regions. The Central region had 30 HCV-reactive samples in 1419 tested for a prevalence of 2.1%. The Western/Finger Lakes region had 36 HCV-reactive samples among 2380 tested for a prevalence of 1.5%. Together these regions had an HCV prevalence of 1.7%. In contrast, HCV prevalence stood at 0.7% in the Hudson/Northeast region, 0.6% in Long Island, and 0.5% in New York City. Statewide HCV prevalence in new mothers came to 0.8%. Thus HCV prevalence in Central and Western New York State was about 3 times higher than in the rest of the state.
Compared with babies born to mothers without HCV antibodies, those born to HCV antibody-positive mothers were born earlier (26% versus 13% with gestational age under 37 weeks) and had lower birth weight (26% versus 11% below 2500 g) (P < 0.001 for both comparisons).
The researchers noted that about 5 times more babies in the state get exposed to HCV (about 1800 in 2019) than to HIV (343 in 2018). Of the 343 infants exposed to HIV in 2018, none got infected.
The New York investigators proposed that "newborn dried blood spot testing using a Luminex-based immunoassay is an effective way to generate a population-based estimate of HCV burden among pregnant women."
Reference
1. Styer LM, Miller E, Rock J, et al. Newborn testing reveals high HCV seroprevalence in pregnant women from New York state. Conference on Retroviruses and Opportunistic Infections (CROI). March 8-11, 2020. Boston. Abstract 125.
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