title: Hepatitis C Virus universal screening versus risk based selective screening during pregnancy.
abstract: OBJECTIVE
  We sought to compare the value of HCV universal screening versus risk-based selective screening in pregnant women.
  
  
  METHODS
  In a prospective observational study (Jan 2012 - March 2012), pregnant women, in a high risk inner city clinic, who were at "low risk" for HCV infection were tested for HCV antibodies (universal screening) and their medical records were compared to the medical records of pregnant women who were at "high risk" (risk based selective screening as assessed by their obstetricians' screening questionnaire).
  
  
  RESULTS
  During the study period, 419 women delivered at our institution with 8.8% (37/419) at high risk for HCV. In 95% (183/193) of available and consenting low risk women, HCV antibody testing was done. The prevalence of HCV was 3.18% (7/220; 95% CI: 1.36-6.50) in all tested women versus 0.95% (4/419; 95% CI: 0.31-2.59) in risk-based selectively tested women. Overall the screening questionnaire had a sensitivity of 0.85 (0.42-0.99) and a specificity of 0.52 (0.45-0.58) in all women who had HCV antibody testing and questionnaire screening.
  
  
  CONCLUSIONS
  Using a screening questionnaire to identify women at risk for HCV infection during pregnancy under-estimates the real prevalence of HCV. A universal screening should be considered in high risk cities.
authors.forename: W
authors.initials: W
authors.lastname: Waruingi
authors.forename: M J
authors.initials: MJ
authors.lastname: Mhanna
authors.forename: D
authors.initials: D
authors.lastname: Kumar
authors.forename: N
authors.initials: N
authors.lastname: Abughali
mesh_terms: D000328:Adult; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018937:Hepatitis C Antibodies
keywords: Hepatitis C Virus; pregnancy; risk-based screening; universal screening