Awareness and Prevalence of Hepatitis C Virus Infection Among Pregnant Women in Nigeria: A National Pilot Cross-Sectional Study
Authors: ELEJE GEORGE UCHENNA , Rabiu Ayyuba , Mbachu Ikechukwu Innocent , Akaba Godwin Otuodichinma , Loto Olabisi Morebise , Usman Hadiza Abdullahi , Fiebai Preye Owen , Chukwuanukwu Rebecca Chinyelu , Joe-Ikechebelu Ngozi Nneka , Nwankwo Chike Henry , Kalu Stephen Okoroafor , Onubogu Chinyere Ukamaka , Ogbuagu Chukwuanugo Nkemakonam , Chukwurah Shirley Nneka , Uzochukwu Chinwe Elizabeth , Inuyomi Samuel Oluwagbenga , Adesoji Bukola Abimbola , Ogwaluonye Uchenna Chukwunonso , Emeka Ekene Agatha , Egeonu Richard Obinwanne , Igue Odion Emmanuel , Jibuaku Chiamaka Henrietta , Okoro Ogbonna Dennis , Aja Prince Ogbonnia , Chidozie Chiamaka Perpetua , Ibrahim Hadiza Sani , Aliyu Fatima Ele , Numan Aisha Ismaila , Omoruyi Solace Amechi , Oppah Ijeoma Chioma , Anyang Ubong Inyang , Ahmed Aishat , Umeononihu Osita Samuel , Umeh Eric Okechukwu , Nweje Sussan Ifeyinwa , Ajuba Ifeoma Clara , Okoro Chukwuemeka Chukwubuikem , Nwaeju Ifeanyi Kingsley , Onwuegbuna Arinze Anthony , Yakasai Ibrahim Adamu , Ezechi Oliver Chukwujekwu , Ikechebelu Joseph Ifeanyichukwu 
Published: March 2021

Abstract
Background: Although hepatitis C virus (HCV) may constitute one of the viral hepatitis with high burden in Nigeria, there is no national data on its awareness and burden among pregnant women to justify its routine screening. Objectives: To investigate awareness, seroprevalence and risk factors for HCV infection among pregnant women in Nigeria.Methods: A total of 159 pregnant women from antenatal clinics across the six geopolitical zones in Nigeria consented to anti-HCV testing by third generation ELISA and confirmed using polymerase chain reaction technique. Confirmed HCV positive women were further tested for hepatitis B and HIV. The women were evaluated for the presence of known risk factors for HCV infection. Odds ratios (ORs), adjusted ORs (aORs) and their 95% confidence intervals (CIs) were determined and p-values of <0.05 were considered significant.Findings: Of the 159 participants, 77 (48.4%; 95% CI, 38.2% to 60.5%) were aware of HCV infection and awareness of HCV was associated with participants’ young age (OR=2.21; 95%CI=1.16 to 4.21), high educational level (OR=3.29; 95%CI=1.63 to 6.64) and participants’ occupation (OR=0.51; 95%CI=0.26 to 0.99). In multivariable logistic regression, adjusted for confounders, the association between awareness of HCV and participants’ young age (aOR=1.60; 95%CI=1.09 to 2.35; p=0.018) and high educational level (aOR=1.48; 95%CI=1.17 to 1.86;p=0.001)remained significant. HCV seroprevalence was found to be 1.3% (95%CI=0.2% to 4.5%). All (100.0%, 95%CI=12.1 to 100.0%) the HCV-positive participants and 99 (63.1%, 95%CI=51.3% to 76.8%) HCV-negative participants had identifiable HCV risk factors. Dual seropositivity of anti-HCV/anti-HIV and anti-HCV/HBsAg each accounted for 1.3% and none of the participants was triply infected or mono-infected with HCV. The more commonly identified risk factors were multiple sexual partners, 25 (15.7%), shared needles, 22 (13.8%), and blood transfusion, 18 (11.3%). The risk factor variables did not have significant association with HCV positive status.Conclusion: There is lack of awareness regarding HCV infection among pregnant women in Nigeria and awareness is positively influenced by young age and high educational level. The prevalence of HCV is high and provides preliminary evidence to justify routine screening in antenatal clinics. There is also a need for enlightenment programs in communities and antenatal clinics. FundingTETFund National Research Fund 2019 (Grant number TETFund/DR&D/CE/NRF/STI/33).