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Am J Perinatol 2021; 38(S 01): e1-e13
DOI: 10.1055/s-0040-1709672
Review Article

Hepatitis C Virus in Pregnancy: A Systematic Review of the Literature

Alexandra Andes
1   Morsani College of Medicine, University of South Florida, Tampa, Florida
,
Kerry Ellenberg
1   Morsani College of Medicine, University of South Florida, Tampa, Florida
,
Amanda Vakos
1   Morsani College of Medicine, University of South Florida, Tampa, Florida
,
James Collins
1   Morsani College of Medicine, University of South Florida, Tampa, Florida
,
Kimberly Fryer
2   Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
› Author Affiliations Funding None.
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Abstract

Objective The aim of this study was to systematically review the literature to summarize recent demographic characteristics of hepatitis C virus (HCV) infection during pregnancy and the efficacy of risk-based versus universal screening.

Study Design PubMed, EMBASE, and Cochrane Library were searched to identify relevant studies. Studies that recognized hepatitis C as a primary or secondary outcome, with pregnant women as the population and written in English, were included. Studies were excluded if they were abstracts only, written in foreign language, or published prior to 1992. Two researchers independently screened all the studies by titles, abstracts, and full text. Conflicts were settled by a third researcher.

Results A total of 698 studies were identified with 78 fitting inclusion criteria. In total, 69 epidemiologic and 9 comparison studies were found. Identified risk factors for HCV infection include intravenous or illicit drug use, sexually transmitted coinfection, high-risk behaviors in the partners, high parity, and history of miscarriages or abortions. Demographic characteristics associated with HCV include non-Hispanic white race, American Indian or Alaskan Native ethnicity, and increasing age. Providers may fail to adequately screen for each risk factor, and up to two-thirds of women with a known risk factor are not screened under current guidelines. Finally, up to 27% of HCV+ women have no identifiable risk factors for infection.

Conclusion There is evidence that risk-based screening fails to identify a large proportion of HCV positive women in pregnancy and that pregnant women with HCV risk factors and consistent with current screening guidelines fail to be tested. We urge for the adoption of universal screening to identify these women and offer treatment.

Keywords

hepatitis C virus - pregnancy - screening - prenatal care


Publication History

Received: 13 September 2019

Accepted: 08 March 2020

Article published online:
22 April 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Center for Disease Control and Prevention. Surveillance Case Definitions for Current and Historical Conditions. Accessed September 2, 2019 at: https://wwwn.cdc.gov/nndss/conditions/
    Google Scholar
  • 2 Scholl L, Seth P, Kariisa M, Wilson N, Baldwin G. Drug and opioid-involved overdose deaths - United States, 2013-2017. MMWR Morb Mortal Wkly Rep 2018; 67 (5152): 1419-1427
    CrossrefPubMedGoogle Scholar
  • 3 AASLD. Recommendations for Testing, Managing, and Treating Hepatitis C. Accessed September 9, 2019 at: https://www.hcvguidelines.org/evaluate
    Google Scholar
  • 4 Hughes BL, Page CM, Kuller JA. ; Society for Maternal-Fetal Medicine (SMFM). Hepatitis C in pregnancy: screening, treatment, and management. Am J Obstet Gynecol 2017; 217 (05) B2-B12
    CrossrefPubMedGoogle Scholar
  • 5 Prasad MR. Hepatitis C virus screening in pregnancy: is it time to change our practice?. Obstet Gynecol 2016; 128 (02) 229-230
    CrossrefPubMedGoogle Scholar
  • 6 Chappell CA, Krans EE, Bunge K. et al. A Phase I study of ledipasvir/sofosbuvir in pregnant women with hepatitis C virus. Accessed September 2, 2019 at: http://www.croiconference.org/sessions/phase-1-study-ledipasvirsofosbuvir-pregnant-women-hepatitis-c-virus
    Google Scholar
  • 7 World Health Organization. Global Hepatitis Report 2017. Geneva, Switzerland: World Health Organization; 2017
    Google Scholar
  • 8 Aniszewska M, Pokorska-Śpiewak M, Kowalik-Mikołajewska B, Pluta M, Marczyńska M. Hepatitis C infection among pregnant women in central Poland: Significance of epidemiological anamnesis and impact of screening tests to detect infection. Adv Clin Exp Med 2019; 28 (03) 313-318
    CrossrefPubMedGoogle Scholar
  • 9 Bohman VR, Stettler RW, Little BB, Wendel GD, Sutor LJ, Cunningham FG. Seroprevalence and risk factors for hepatitis C virus antibody in pregnant women. Obstet Gynecol 1992; 80 (04) 609-613
    PubMedGoogle Scholar
  • 10 Ward C, Tudor-Williams G, Cotzias T, Hargreaves S, Regan L, Foster GR. Prevalence of hepatitis C among pregnant women attending an inner London obstetric department: uptake and acceptability of named antenatal testing. Gut 2000; 47 (02) 277-280
    CrossrefPubMedGoogle Scholar
  • 11 Wahl M, Hermodsson S, Leman J. et al. Prevalence of antibodies against hepatitis B and C virus among pregnant women and female blood donors in Sweden. Serodiagn Immunother Infect Dis 1994; 6 (03) 127-129
    CrossrefPubMedGoogle Scholar
  • 12 Nolen LD, O'Malley JC, Seeman SS. et al. Hepatitis C in pregnant American Indian and Alaska native women; 2003-2015. Int J Circumpolar Health 2019; 78 (01) 1608139
    CrossrefPubMedGoogle Scholar
  • 13 Floreani A, Paternoster D, Zappala F. et al. Hepatitis C virus infection in pregnancy. Br J Obstet Gynaecol 1996; 103 (04) 325-329
    CrossrefPubMedGoogle Scholar
  • 14 Garner JJ, Gaughwin M, Dodding J, Wilson K. Prevalence of hepatitis C infection in pregnant women in South Australia. Med J Aust 1997; 167 (09) 470-472
    CrossrefPubMedGoogle Scholar
  • 15 Goldberg D, McIntyre PG, Smith R. et al. Hepatitis C virus among high and low risk pregnant women in Dundee: unlinked anonymous testing. BJOG 2001; 108 (04) 365-370
    PubMedGoogle Scholar
  • 16 Leikin EL, Reinus JF, Schmell E, Tejani N. Epidemiologic predictors of hepatitis C virus infection in pregnant women. Obstet Gynecol 1994; 84 (4 I): 529-534
    PubMedGoogle Scholar
  • 17 Pembrey L, Newell ML, Tovo PA. European paediatric hepatitis C virus network. Antenatal hepatitis C virus screening and management of infected women and their children: Policies in Europe. Eur J Pediatr 1999; 158 (10) 842-846
    CrossrefPubMedGoogle Scholar
  • 18 Sfameni SF, Francis B, Wein P. Seroprevalence and assessment of risk factors for hepatitis C virus infection in pregnancy. Aust N Z J Obstet Gynaecol 2000; 40 (03) 263-267
    CrossrefPubMedGoogle Scholar
  • 19 Salemi JL, Spooner KK, Mejia de Grubb MC, Aggarwal A, Matas JL, Salihu HM. National trends of hepatitis B and C during pregnancy across sociodemographic, behavioral, and clinical factors, United States, 1998-2011. J Med Virol 2017; 89 (06) 1025-1032
    CrossrefPubMedGoogle Scholar
  • 20 Silverman NS, Jenkin BK, Wu C, McGillen P, Knee G. Hepatitis C virus in pregnancy: seroprevalence and risk factors for infection. Am J Obstet Gynecol 1993; 169 (03) 583-587
    CrossrefPubMedGoogle Scholar
  • 21 Dodge JL, Terrault NA. Sexual transmission of hepatitis C: a rare event among heterosexual couples. J Coagul Disord 2014; 4 (01) 38-39
    PubMedGoogle Scholar
  • 22 Simpore J, Ilboudo D, Krou D. et al. Prevalence of HHV-8 infections associated with HIV, HBV and HCV in pregnant women in Burkina Faso. J Med Sci 2006; 6 (01) 93-98
    PubMedGoogle Scholar
  • 23 Urbanus AT, van de Laar TJW, van den Hoek A. et al. Hepatitis C in the general population of various ethnic origins living in the Netherlands: should non-Western migrants be screened?. J Hepatol 2011; 55 (06) 1207-1214
    CrossrefPubMedGoogle Scholar
  • 24 Khamis HH, Farghaly AG, Shatat HZ, El-Ghitany EM. Prevalence of hepatitis C virus infection among pregnant women in a rural district in Egypt. Trop Doct 2016; 46 (01) 21-27
    CrossrefPubMedGoogle Scholar
  • 25 Costa ZB, Machado GC, Avelino MM. et al. Prevalence and risk factors for Hepatitis C and HIV-1 infections among pregnant women in Central Brazil. BMC Infect Dis 2009; 9: 116
    CrossrefPubMedGoogle Scholar
  • 26 El-Kamary SS, Hashem M, Saleh DA. et al. Reliability of risk-based screening for hepatitis C virus infection among pregnant women in Egypt. J Infect 2015; 70 (05) 512-519
    CrossrefPubMedGoogle Scholar
  • 27 Khattak ST, Ali Marwat M, Khattak Iu, Khan TM, Naheed T. Comparison of frequency of hepatitis B and hepatitis C in pregnant women in urban and rural area of district Swat. J Ayub Med Coll Abbottabad 2009; 21 (02) 12-15
    PubMedGoogle Scholar
  • 28 Kumari K, Seetlani NK, Akhter R. The emergent concern of seropositive status of hepatitis-B virus and hepatitis-C virus in the pregnant females attending a tertiary care hospital. J Ayub Med Coll Abbottabad 2015; 27 (01) 155-157
    PubMedGoogle Scholar
  • 29 Wilson E, Beckmann M. Antenatal screening for hepatitis C: Universal or risk factor based?. Aust N Z J Obstet Gynaecol 2015; 55 (04) 318-322
    CrossrefPubMedGoogle Scholar
  • 30 Yousfani S, Mumtaz F, Memon A, Memon MA, Sikandar R. Antenatal screening for hepatitis B and C virus carrier state at a University Hospital. J Liaquat Univ Med Heal Sci 2006; 5 (01) 24-27
    CrossrefPubMedGoogle Scholar
  • 31 Al-Kubaisy WA, Niazi AD, Kubba K. History of miscarriage as a risk factor for hepatitis C virus infection in pregnant Iraqi women. East Mediterr Health J 2002; 8 (2-3): 239-244
    CrossrefPubMedGoogle Scholar
  • 32 Baldo V, Floreani A, Menegon T, Grella P, Paternoster DM, Trivello R. Hepatitis C virus, hepatitis B virus and human immunodeficiency virus infection in pregnant women in North-East Italy: a seroepidemiological study. Eur J Epidemiol 2000; 16 (01) 87-91
    CrossrefPubMedGoogle Scholar
  • 33 Salihu HM, Connell L, Salemi JL, August EM, Weldeselasse HE, Alio AP. Prevalence and temporal trends of hepatitis B, hepatitis C, and HIV/AIDS co-infection during pregnancy across the decade, 1998-2007. J Womens Health (Larchmt) 2012; 21 (01) 66-72
    CrossrefPubMedGoogle Scholar
  • 34 Boxall E, Skidmore S, Evans C, Nightingale S. The prevalence of hepatitis B and C in an antenatal population of various ethnic origins. Epidemiol Infect 1994; 113 (03) 523-528
    CrossrefPubMedGoogle Scholar
  • 35 Lazenby GB, Orr C, Guille C, Meissner EG. Increasing prevalence of chronic hepatitis C virus infection in a southern academic obstetrical clinic. South Med J 2019; 112 (06) 325-330
    CrossrefPubMedGoogle Scholar
  • 36 Apea-Kubi KA, Yamaguchi S, Sakyi B, Ofori-Adjei D. HTLV-1 and other viral sexually transmitted infections in antenatal and gynaecological patients in Ghana. West Afr J Med 2006; 25 (01) 17-21
    PubMedGoogle Scholar
  • 37 Blasig A, Wagner EC, Pi D. et al. Hepatitis C infection among pregnant women in British Columbia: Reported prevalence and critical appraisal of current prenatal screening methods. Can J Public Heal 2011; 102 (02) 98-102
    CrossrefPubMedGoogle Scholar
  • 38 Duru MU, Aluyi HSA, Anukam KC. Rapid screening for co-infection of HIV and HCV in pregnant women in Benin City, Edo State, Nigeria. Afr Health Sci 2009; 9 (03) 137-142
    PubMedGoogle Scholar
  • 39 Njouom R, Pasquier C, Ayouba A. et al. Hepatitis C virus infection among pregnant women in Yaounde, Cameroon: prevalence, viremia, and genotypes. J Med Virol 2003; 69 (03) 384-390
    CrossrefPubMedGoogle Scholar
  • 40 Orkin C, Jeffery-Smith A, Foster GR, Tong CYW. Retrospective hepatitis C seroprevalence screening in the antenatal setting-should we be screening antenatal women?. BMJ Open 2016; 6 (05) e010661
    CrossrefPubMedGoogle Scholar
  • 41 Boudova S, Mark K, El-Kamary SS. Risk-based hepatitis C screening in pregnancy is less reliable than universal screening: a retrospective chart review. Open Forum Infect Dis 2018; 5 (03) ofy043
    CrossrefPubMedGoogle Scholar
  • 42 Nolen LD, Gustin C, Seeman S. et al. Risk-based prenatal hepatitis C testing practices and results, Alaska 2013–2016. Can J Gastroenterol Hepatol 2019; 2019: 8654741
    CrossrefPubMedGoogle Scholar
  • 43 Diab-Elschahawi M, Dosch V, Honsig C. et al. Evaluation of a universal vs a targeted hepatitis C virus screening strategy among pregnant women at the Vienna University Hospital. Am J Infect Control 2013; 41 (05) 459-460
    CrossrefPubMedGoogle Scholar
  • 44 Lambert J, Jackson V, Coulter-Smith S. et al. Universal antenatal screening for hepatitis C. Ir Med J 2013; 106 (05) 136-139
    PubMedGoogle Scholar
  • 45 Waruingi W, Mhanna MJ, Kumar D, Abughali N. Hepatitis C Virus universal screening versus risk based selective screening during pregnancy. J Neonatal Perinatal Med 2015; 8 (04) 371-378
    CrossrefPubMedGoogle Scholar
  • 46 Martyn F, Phelan O, O'Connell M. Hepatitis C: is there a case for universal screening in pregnancy?. Ir Med J 2011; 104 (05) 144-146
    PubMedGoogle Scholar
  • 47 McDermott CD, Moravac CC, Yudin MH. The effectiveness of screening for hepatitis C in pregnancy. J Obstet Gynaecol Can 2010; 32 (11) 1035-1041
    CrossrefPubMedGoogle Scholar
  • 48 Bone C, Gelberg L, Vahidi M, Leake B, Yacenda-Murphy J, Andersen RM. Under-reporting of risky drug use among primary care patients in federally qualified health centers. J Addict Med 2016; 10 (06) 387-394
    CrossrefPubMedGoogle Scholar
  • 49 National Center for Health Statistics. Provisional drug overdose death counts. 2020 . Accessed January 29, 2020 at: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
    Google Scholar
  • 50 Access in Brief: Pregnant Women and Medicaid. Accessed February 18, 2020 at: https://www.macpac.gov/wp-content/uploads/2018/11/Pregnant-Women-and-Medicaid.pdf
    Google Scholar
  • 51 Tasillo A, Eftekhari Yazdi G, Nolen S. et al. Short-term effects and long-term cost-effectiveness of universal hepatitis C testing in prenatal care. Obstet Gynecol 2019; 133 (02) 289-300
    CrossrefPubMedGoogle Scholar
  • 52 Chaillon A, Rand EB, Reau N, Martin NK. Cost-effectiveness of universal hepatitis C virus screening of pregnant women in the United States. Clin Infect Dis 2019; 69 (11) 1888-1895
    CrossrefPubMedGoogle Scholar
  • 53 Afsheen Z, Ahmad B, Bashir S. Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan. Virol J 2017; 14 (01) 195
    CrossrefPubMedGoogle Scholar
  • 54 Al-Kubaisy W, Daud S, Al-Kubaisi MW, Al-Kubaisi OW, Abdullah NN. Maternal hepatitis C (HCV) infection and anti-D immunoglobulin therapy: study testing antibodies, RNA and genotype of HCV in Baghdad. J Maternal-Fetal Neonat Med 2019; 32 (20) 3464-3469
    CrossrefPubMedGoogle Scholar
  • 55 Al-Mandeel H, Alansary M, Algawahmed F, Al-Mojally H, Alfaleh K, Aldakhyel L. Seroprevalence of hepatitis B and C, and human immunodeficiency viruses in Saudi pregnant women and rates of vertical transmission. Kuwait Med J 2015; 47 (03) 221-224
    PubMedGoogle Scholar
  • 56 Benjelloun S, Bahbouhi B, Sekkat S, Bennani A, Hda N, Benslimane A. Anti-HCV seroprevalence and risk factors of hepatitis C virus infection in Moroccan population groups. Res Virol 1996; 147 (04) 247-255
    CrossrefPubMedGoogle Scholar
  • 57 Buseri F, Seiyaboh E, Jeremiah Z. Surveying infections among pregnant women in the Niger Delta, Nigeria. J Glob Infect Dis 2010; 2 (03) 203-211
    CrossrefPubMedGoogle Scholar
  • 58 Cortina-Borja M, Williams D, Peckham CS, Bailey H, Thorne C. Hepatitis C virus seroprevalence in pregnant women delivering live-born infants in North Thames, England in 2012. Epidemiol Infect 2016; 144 (03) 627-634
    CrossrefPubMedGoogle Scholar
  • 59 Dabsu R, Ejeta E. Seroepidemiology of Hepatitis B and C virus infections among pregnant women attending antenatal clinic in selected health facilities in East Wollega Zone, West Oromia, Ethiopia. BioMed Res Int 2018; 2018: 4792584
    CrossrefPubMedGoogle Scholar
  • 60 De Paschale M, Ceriani C, Cerulli T. et al. Prevalence of HBV, HDV, HCV, and HIV infection during pregnancy in northern Benin. J Med Virol 2014; 86 (08) 1281-1287
    CrossrefPubMedGoogle Scholar
  • 61 Fouelifack FY, Fouedjio JH, Fouogue JT, Fouelifa LD. Seroprevalences and Correlates of Hepatitis B and C Among Cameroonian Pregnant Women. Clin Med Insights Reprod Health 2018; 12: 1179558118770671
    CrossrefPubMedGoogle Scholar
  • 62 Goyal LD, Kaur S, Jindal N, Kaur H. HCV and pregnancy: prevalence, risk factors, and pregnancy outcome in north Indian population: a case-control study. J Obstet Gynaecol India 2014; 64 (05) 332-336
    CrossrefPubMedGoogle Scholar
  • 63 Hilda AE, Kola OJ, Kolawole OE. Prevalence of anti-hepatitis C virus antibody among pregnant women and blood donors at Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria. J Immunoassay Immunochem 2017; 38 (02) 221-234
    CrossrefPubMedGoogle Scholar
  • 64 Hutchinson SJ, Goldberg DJ, King M. et al. Hepatitis C virus among childbearing women in Scotland: prevalence, deprivation, and diagnosis. Gut 2004; 53 (04) 593-598
    CrossrefPubMedGoogle Scholar
  • 65 Kristiansen MG, Eriksen BO, Maltau JM. et al. Prevalences of viremic hepatitis C and viremic hepatitis B in pregnant women in Northern Norway. Hepatogastroenterology 2009; 56 (93) 1141-1145
    PubMedGoogle Scholar
  • 66 Kopilović B, Poljak M, Seme K, Klavs I. Hepatitis C virus infection among pregnant women in Slovenia: study on 31,849 samples obtained in four screening rounds during 1999, 2003, 2009 and 2013. Euro Surveill 2015; 20 (22) 21144
    CrossrefPubMedGoogle Scholar
  • 67 Kumar RM, Frossad PM, Hughes PF. Seroprevalence and mother-to-infant transmission of hepatitis C in asymptomatic Egyptian women. Eur J Obstet Gynecol Reprod Biol 1997; 75 (02) 177-182
    CrossrefPubMedGoogle Scholar
  • 68 Kumar A, Sharma KA, Gupta RK, Kar P, Chakravarti A. Prevalence & risk factors for hepatitis C virus among pregnant women. Indian J Med Res 2007; 126 (03) 211-215
    PubMedGoogle Scholar
  • 69 Kuo M, Money DM, Alvarez M. et al. Test uptake and case detection of syphilis, HIV, and hepatitis C among women undergoing prenatal screening in British Columbia, 2007 to 2011. J Obstet Gynaecol Can 2014; 36 (06) 482-490
    CrossrefPubMedGoogle Scholar
  • 70 Lembo T, Saffioti F, Chiofalo B. et al. Low prevalence of hepatitis B and hepatitis C virus serum markers in a cohort of pregnant women from Southern Italy. Dig Liver Dis 2017; 49 (12) 1368-1372
    CrossrefPubMedGoogle Scholar
  • 71 Madzime S, William MA, Mohamed K. et al. Seroprevalence of hepatitis C virus infection among indigent urban pregnant women in Zimbabwe. Cent Afr J Med 2000; 46 (01) 1-4
    PubMedGoogle Scholar
  • 72 Mehta KD, Antala S, Mistry M, Goswami Y. Seropositivity of hepatitis B, hepatitis C, syphilis, and HIV in antenatal women in India. J Infect Dev Ctries 2013; 7 (11) 832-837
    CrossrefPubMedGoogle Scholar
  • 73 Mohebbi SR, Sanati A, Cheraghipour K, Rostami Nejad M, Shalmani HM, Zali MR. Hepatitis C and hepatitis B virus infection: epidemiology and risk factors in a large cohort of pregnant women in Lorestan, West of Iran. Hepat Mon 2011; 11 (09) 736-739
    CrossrefPubMedGoogle Scholar
  • 74 Molla S, Munshea A, Nibret E. Seroprevalence of hepatitis B surface antigen and anti HCV antibody and its associated risk factors among pregnant women attending maternity ward of Felege Hiwot Referral Hospital, northwest Ethiopia: a cross-sectional study. Virol J 2015; 12 (01) 204
    CrossrefPubMedGoogle Scholar
  • 75 Murad EA, Babiker SM, Gasim GI, Rayis DA, Adam I. Epidemiology of hepatitis B and hepatitis C virus infections in pregnant women in Sana'a, Yemen. BMC Pregnancy Childbirth 2013; 13 (01) 127
    CrossrefPubMedGoogle Scholar
  • 76 Ndumbe PM, Skalsky J. Hepatitis C virus infection in different populations in Cameroon. Scand J Infect Dis 1993; 25 (06) 689-692
    CrossrefPubMedGoogle Scholar
  • 77 Ogunro PS, Adekanle DA, Fadero FF, Ogungbamigbe TO, Oninla SO. Prevalence of anti-hepatitis C virus antibodies in pregnant women and their offspring in a tertiary hospital in Southwestern Nigeria. J Infect Dev Ctries 2007; 1 (03) 333-336
    CrossrefPubMedGoogle Scholar
  • 78 Ohto H, Ishii T, Kitazawa J. et al. Declining hepatitis C virus (HCV) prevalence in pregnant women: impact of anti-HCV screening of donated blood. Transfusion 2010; 50 (03) 693-700
    CrossrefPubMedGoogle Scholar
  • 79 Okusanya BO, Aigere EOS, Eigbefoh JO, Ikheloa J. Seroprevalence and clinico-epidemiological correlates of hepatitis C viral antibodies at an antenatal booking clinic of a tertiary hospital in Nigeria. Arch Gynecol Obstet 2013; 288 (03) 495-500
    CrossrefPubMedGoogle Scholar
  • 80 Opaleye OO, Igboama MC, Ojo JA, Odewale G. Seroprevalence of HIV, HBV, HCV, and HTLV among pregnant women in Southwestern Nigeria. J Immunoassay Immunochem 2016; 37 (01) 29-42
    CrossrefPubMedGoogle Scholar
  • 81 Osazuwa F. Sero-epidemiology of human immunodeficency virus, Hepatitis B and C among pregnant women in rural communities of Abaji Area Council, Nigeria. Turk Silahli Kuvvetleri Koruyucu Hekim Bul 2012; 11 (04) 431-438
    PubMedGoogle Scholar
  • 82 Prasad LR, Massery Spicher V, Kammerlander R, Zwahlen M. Hepatitis C in a sample of pregnant women in Switzerland: seroprevalence and socio-demographic factors. Swiss Med Wkly 2007; 137 (1-2): 27-32
    PubMedGoogle Scholar
  • 83 Puro V, Girardi E, Ippolito G. et al. Prevalence of hepatitis B and C viruses and human immunodeficiency virus infections in women of reproductive age. Br J Obstet Gynaecol 1992; 99 (07) 598-600
    CrossrefPubMedGoogle Scholar
  • 84 Kumar KGR, Babu KVY, Chandrappa NR, Hanumanthappa AR. Prevalence of hepatitis C virus in a sample of pregnant women in Davangere: Survey by antibody detection. J Pure Appl Microbiol 2012; 6 (01) 429-432
    PubMedGoogle Scholar
  • 85 Rouet F, Chaix M-L, Inwoley A. et al; ANRS 1236 DITRAME-B&C Study Group. HBV and HCV prevalence and viraemia in HIV-positive and HIV-negative pregnant women in Abidjan, Côte d'Ivoire: the ANRS 1Vijayanath V236 study. J Med Virol 2004; 74 (01) 34-40
    CrossrefPubMedGoogle Scholar
  • 86 Sami S, Korejo R, Bhutta SZ. Prevalence of hepatitis B and C: a Jinnah postgraduate medical centre experience. J Obstet Gynaecol Res 2009; 35 (03) 533-538
    CrossrefPubMedGoogle Scholar
  • 87 Sheikh SM. Hepatitis B and C: value of universal antenatal screening. J Coll Physicians Surg Pak 2009; 19 (03) 179-182
    PubMedGoogle Scholar
  • 88 Spencer JD, Tibbits D, Tippet C, Mead C, Kaldor JM, Dore GJ. Review of antenatal testing policies and practice for HIV and hepatitis C infection. Aust N Z J Public Health 2003; 27 (06) 614-619
    CrossrefPubMedGoogle Scholar
  • 89 Taseer IU, Ishaq F, Hussain L, Safdar S, Mirbahar AM, Faiz SA. Frequency of anti-HCV, HBsAg and related risk factors in pregnant women at Nishtar Hospital, Multan. J Ayub Med Coll Abbottabad 2010; 22 (01) 13-16
    PubMedGoogle Scholar
  • 90 Tiruneh M. Seroprevalence of multiple sexually transmitted infections among antenatal clinic attendees in Gondar Health Center, northwest Ethiopia. Ethiop Med J 2008; 46 (04) 359-366
    PubMedGoogle Scholar
  • 91 Völker F, Cooper P, Bader O. et al. Prevalence of pregnancy-relevant infections in a rural setting of Ghana. BMC Pregnancy Childbirth 2017; 17 (01) 172
    CrossrefPubMedGoogle Scholar
  • 92 Walewska-Zielecka B, Religioni U, Juszczyk G, Czerw A, Wawrzyniak Z, Soszyński P. Diagnosis of hepatitis C virus infection in pregnant women in the healthcare system in Poland: is it worth the effort?. Medicine (Baltimore) 2016; 95 (30) e4331
    CrossrefPubMedGoogle Scholar