Timing of Earliest Documented Positive Hepatitis C Laboratory Result Relative to Delivery Among Pregnant Persons With Active Infection in West Virginia, 2022–2023

Direct-acting antiviral therapy can cure hepatitis C virus (HCV) infection; however, because treatment is not recommended during pregnancy, preconception treatment remains the primary strategy to prevent perinatal HCV exposure. West Virginia birth records from 2022 to 2023 were linked with statewide HCV laboratory surveillance data. This linked dataset was used to identify births to persons with active HCV infection and characterize the timing of the earliest documented positive HCV laboratory result relative to delivery. A total of 426 deliveries resulting in 433 HCV-exposed live-born infants were identified. Most pregnant persons were aged 25-34 years, White and insured by Medicaid. Overall, 38.5% had their earliest documented positive HCV laboratory result more than 5 years prior to delivery, 36.9% had their first documented positive test 1-5 years prior to delivery and 24.6% had their first documented positive test within 1 year before delivery and up to 2 weeks postpartum. These findings indicate that many pregnant persons with active HCV infection had documented longstanding infection prior to pregnancy, highlighting opportunities to strengthen linkage to care and access to curative treatment before pregnancy.