Tracy McClinton DNP, AG-ACNP-BC and Sharon Little DNP, FNP-BC, APRN
Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.
Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles were screened to exclude those that only focused on men (N=2) and women who were not pregnant (N=5). Six final articles were selected for scoping review, comparing the outcomes of women between 18 and 35 years of age who were at high risk of HCV and who received prenatal HCV screening to those who were not screened. The study further explores the health outcome associated with early detection of HCV in high-risk pregnant women and the vertical transmission rate from mother to newborn baby.
Results According to the reviewed studies, early screening and prompt treatment during pregnancy can prevent most mother-to-child transmissions and thus most childhood cases of HCV. Interventions and outcomes noted in the articles selected are to increase screening in infants at risk for perinatal HCV acquisition by including technology to improve the transfer of maternal HCV status to the pediatric record and increase pediatric provider awareness regarding HCV screening guidelines.
Implications for Nursing Practice The studies demonstrate that universal HCV screening is efficient, cost-effective, and beneficial when long-term needs are present (Baranoski, 2016). Following the recommendations, universal HCV screening with HCV antibodies and reflex HCV RNA testing may soon become standard practice in the United States. Therefore, it is imperative to review and incorporate this into the curriculum and training proactively.
Baranoski, A. S., Cotton, D., Horsburgh, C. R., Kubiak, R. W., Heeren, T., Nunes, D. (2016). Clinical liver disease progression among hepatitis C infected drug users with CD4 cell count less than 200 cells/mm3 is more pronounced among women than men. Open Forum Infectious Diseases, 3(1). https://doi-org.ezproxy.uthsc.edu/10.1093/ofid/ofv214.
Chappell, C. A., Hillier, S. L., Crowe, D., Meyn, L. A., Bogen, D. L., & Krans, E. E. (2018). Hepatitis C Virus Screening Among Children Exposed During Pregnancy. Pediatrics, 141(6), e20173273. https://doi.org/10.1542/peds.2017-3273.
Watts, T., Stockman, L., Martin, J., Guilfoyle, S., & Vergeront, J. M. (2017). Increased Risk for Mother-to-Infant Transmission of Hepatitis C Virus Among Medicaid Recipients - Wisconsin, 2011- 2015. MMWR. Morbidity and mortality weekly report, 66(42), 1136–1139. https://doi.org/10.15585/mmwr.mm6642a3
Adebiyi, Sadiat Omowunmi BSN, RN; Shaw, Sakinah BSN, RN; McClinton, Tracy DNP, AG-ACNP-BC; and Little, Sharon DNP, FNP-BC, APRN , "Annual Hepatitis C Screening QI: A Scoping Review" (2022). Doctor of Nursing Practice Projects. Paper 26. http://dx.doi.org/10.21007/con.dnp.2022.0026.
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