P131 Routine screening of hepatitis C in an antenatal setting – single centre experience

<h3>Background</h3> Hepatitis C virus (HCV) remains a major health concern globally accounting for approximately 290,000 deaths and 1.5 million new infections annually. The United Kingdom (UK) has committed to the World Health Organization’s viral hepatitis elimination targets which aim to support the elimination of viral hepatitis as a public health threat by the year 2030. New case-finding strategies, such as antenatal testing, may be needed to achieve the target. Universal opt-out HCV testing is not currently recommended as part of antenatal screening in the UK because of low risk of mother-to-child transmission, lack of evidence on the efficacy of treatment for HCV in pregnancy, and treatment not being recommended for babies. Bradford being an area with high HCV prevalence, we rolled out a screening program for HCV testing in the antenatal clinic to evaluate the feasibility of this case-finding strategy. <h3>Method</h3> After discussion with the antenatal team, we added HCV antibody test to the antenatal screening panel which included HIV, Hepatitis B and syphilis serology. This panel can be ordered on our electronic system as a ‘one touch’ request. We agreed with the laboratory that positive HCV Ab tests would be reflexly tested for HCV PCR. We interrogated our electronic database to obtain the following: number of pregnancies, demographics, uptake of the new antenatal screening panel and number of positive HCV Ab/PCR tests. <h3>Results</h3> Between October 2022 to March 2024 (17 months), there were 9383 pregnancies registered with the antenatal service (5031 (53.6%) Asians, 3051(32.5%) Caucasians, 605(6.4%) Black ethnicity,188 (2%) mixed population and 494(5.2%) others). 9066 pregnancies (96.6%) were screened for HCV antibody. 57(0.62%) tested positive for HCV antibody (39(68.4%) Asians, 13(22%) Caucasians,5 (8.7%) others). 7/57(12.2%) were HCV PCR positive (5(71.4%) Asians; 2(28.6%) Caucasians). 50/57 were HCV antibody positive but PCR negative, 11 (22%) of whom had received treatment for HCV before their pregnancies and 39(78%) having spontaneously cleared HCV which was higher than expected. 2/7 of the HCV PCR-positive cases have been started on treatment, the remaining 5 awaiting treatment post-partum. <h3>Conclusion</h3> Screening for HCV was very successful in the antenatal setting, 97% taking up the test. The prevalence of HCV Ab (0.62%) in our population reflects the UK prevalence. These figures show that antenatal case finding is feasible and will help towards HCV elimination in the UK, hopefully before the WHO deadline of 2030. We would recommend national rollout of case finding in the antenatal setting.