The Next Frontier: Universal HCV Screening in pregnant women.
There is worldwide enthusiasm for the elimination of hepatitis C (HCV). The availability of highly effective and safe direct acting anti-viral agents to treat almost everyone with HCV infection means that HCV elimination is now primarily a public health challenge. Making progress towards HCV elimination requires screening to increase the proportion of HCV-infected persons who are aware of their status, linking to and retaining them in care to achieve cure, and increasing access to harm reduction services to prevent new infections. Historically, the majority of HCV-infected persons were “baby boomers” born during 1945-1965. Since the Centers for Disease Control recommended one-time HCV screening of baby boomers in 2012, the HCV prevalence in that population has decline with many have been identified and treated. Concurrently, there has been an increase in HCV prevalence among young adults using injection drugs. An important consequence of this changing epidemiology has been an increase in the number of HCV-infected women of childbearing age and HCV-exposed infants. Developing comprehensive programs and policies to identify, treat, and prevent perinatal HCV-transmission will play an important role in achieving the public health goal of HCV elimination.