title: Reliability of risk-based screening for hepatitis C virus infection among pregnant women in Egypt.
abstract: OBJECTIVE
  The Centers for Disease Control and Prevention (CDC) only recommends risk-based HCV screening for pregnant women in the United States. This study sought to determine the reliability of risk-based versus universal HCV screening for pregnant women in Egypt, a country with the world's highest HCV prevalence that also relies on risk-based screening, and to identify additional characteristics that could increase the reliability of risk-based screening.
  
  
  METHODS
  Pregnant women attending the Cairo University antenatal clinic were tested for anti-HCV antibodies and RNA, and demographic characteristics and risk factors for infection were assessed.
  
  
  RESULTS
  All 1250 pregnant women approached agreed to participate (100%) with a mean age of 27.4 ± 5.5 years (range:16-45). HCV antibodies and RNA were positive in 52 (4.2%) and 30 (2.4%) women respectively. After adjustment, only age (OR:1.08, 95%CI:1.002-1.16, p < 0.01), history of prior pregnancies (OR:1.20, 95%CI:1.01-1.43, p < 0.04), and working in the healthcare sector (OR:8.68, 95%CI:1.72-43.62, p < 0.01), remained significantly associated with chronic HCV infection.
  
  
  CONCLUSIONS
  Universal antenatal HCV screening was widely accepted (100%) and traditional risk-based screening alone would have missed 3 (10%) chronically infected women, thereby supporting universal screening of pregnant women whenever possible. Otherwise, risk-based screening should be modified to include history of prior pregnancy and healthcare employment.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: selkamar@epi.umaryland.edu.
authors.forename: Samer S
authors.initials: SS
authors.lastname: El-Kamary
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hashem
authors.affiliation: Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Doa'a A
authors.initials: DA
authors.lastname: Saleh
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ehab
authors.affiliation: Department of Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Sahar A
authors.initials: SA
authors.lastname: Sharaf
authors.affiliation: Department of Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Fatma
authors.initials: F
authors.lastname: El-Mougy
authors.affiliation: Department of Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Lobna
authors.initials: L
authors.lastname: Abdelsalam
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, NC, USA.
authors.forename: Ravi
authors.initials: R
authors.lastname: Jhaveri
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Aboulnasr
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: El-Ghazaly
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004534:Egypt / Q000453:epidemiology; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D055815:Young Adult
chemical_list: D018937:Hepatitis C Antibodies
keywords: Egypt; Hepatitis C; Mass screening; Pregnancy; Risk factors