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BACKGROUND: Kentucky (KY) had the highest rate of acute Hepatitis C (HCV) cases in the United States in 2012. Since 2012, laboratory testing of at-risk individuals has revealed a large number of HCV-positive tests in the 20-29 year age group. This observation heightened concerns about the potential for perinatal HCV transmission. The KY Adult Viral Hepatitis Prevention Program requested healthcare providers to voluntarily report all HCV-positive pregnant women; all infants born to HCV-positive women; and all HCV-positive children aged 0 to 5 years to monitor geographic and temporal trends of perinatal HCV transmission.
METHODS: Perinatal hepatitis reports were collected from December 20, 2013 through December 21, 2014, including information on hepatitis markers, laboratory values, risk factors, and vaccination history of pregnant women or children under the age of 5 years. These data were entered and maintained in EpiInfo. Descriptive analyses were performed using SPSS v.20.
RESULTS: Over one year, 510 perinatal hepatitis cases (85 perinatal Hepatitis B (HBV); 425 HCV) were reported to the Kentucky Department for Public Health. Of the reported 425 HCV cases, 380 (89.4%) were pregnant women (14 to 47 years; mean=27 years) and 43 (10.1%) were children. Eighteen children tested positive for HCV-antibody, of which four had a positive HCV RNA test. Out of 357 pregnant women tested for HCV-antibody, 356 tested positive, with 70 positive and 25 negative with HCV RNA test. One pregnant woman with negative HCV-antibody test had a positive HCV RNA test. Among 425 perinatal HCV cases, injection drug use (IDU) was reported for 163 cases, multiple sex partners for 73 cases, tattoos for 23, history of STDs for 16, and exposure to a known HBV- or HCV-positive contact for 20. There were no cases with known reported positive HIV status.
CONCLUSIONS: This report demonstrates the importance of perinatal HCV surveillance for monitoring its geographic and temporal trends of transmission in Kentucky. Perinatal HCV reporting has been included in an amendment to the reportable diseases surveillance regulation and will become effective in 2015. Further cooperation from local health departments and healthcare providers is needed for successful tracking of the vulnerable population at risk and may help target resources and prevention services more appropriately throughout the Commonwealth.