title: Declining hepatitis C virus (HCV) prevalence in pregnant women: impact of anti-HCV screening of donated blood.
abstract: BACKGROUND
  Screening blood donors for hepatitis C virus (HCV) antibody has effectively mitigated transfusion transmission of HCV. We conducted a post hoc analysis to clarify the impact of donor screening on a general population of reproductive-age females and their offspring.
  
  
  METHODS
  Anti-HCV screening in Japan started in late-1989. In a cohort studied between May 1990 and November 2004, a total of 22,664 consecutive serum samples from pregnant women were screened for anti-HCV. Reactive samples were further tested for HCV RNA. Linear structural regression was applied to identify causal relationships.
  
  
  RESULTS
  Anti-HCV-reactive rates declined significantly by two measures. First, among women known to have been transfused, rates fell from 14.8% to 3.1% with the implementation of anti-HCV screening (p < 0.01). Nevertheless, this is 10 times higher than the 0.3% reactive rate seen in a similar cohort of nontransfused women. Second, rates fell from 1.8% among women born in 1955 or before to 0.3% for women born in 1966 or later (p < 0.01). Among 103 anti-HCV-reactive women, 31 (30%) had been transfused and another 17 (17%) had other identifiable risk factors. The remaining 55 (53%) had no clear risk factor. Blood transfusion accounted for 19% of anti-HCV acquisition, by path analysis. Only one infant in this cohort was vertically infected with HCV.
  
  
  CONCLUSIONS
  Anti-HCV screening of donated blood and hygienic improvements have markedly decreased HCV infection of pregnant women with a transfusion history; however, 70% of anti-HCV-reactive women were deemed to be infected via routes other than transfusion.
authors.affiliation: Division of Blood Transfusion and Transplantation Immunology, Fukushima Medical University Hospital, Fukushima, Japan. hit-ohto@fmu.ac.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ohto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Ishii
authors.forename: Junichi
authors.initials: J
authors.lastname: Kitazawa
authors.forename: Seiji
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Niro
authors.initials: N
authors.lastname: Ujiie
authors.forename: Keiya
authors.initials: K
authors.lastname: Fujimori
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Ariga
authors.forename: Tomoko
authors.initials: T
authors.lastname: Satoh
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Nollet
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Okamoto
authors.forename: Tanji
authors.initials: T
authors.lastname: Hoshi
mesh_terms: D001782:Blood Donors; D015331:Cohort Studies; D046148:Donor Selection; D005260:Female; D016174:Hepacivirus; D006526:Hepatitis C / Q000097:blood* / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D011247:Pregnancy / Q000097:blood; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000453:epidemiology; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood*
chemical_list: D012367:RNA, Viral