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 , Onwuegbuna Arinze Anthony , Igbodike Emeka Philip , Nwaeju Ifeanyi Kingsley , Yakasai Ibrahim Adamu , Ezechi Oliver Chukwujekwu , Ikechebelu Joseph Ifeanyichukwu 
Published: July 2021

Background: There are no national data on hepatitis C virus awareness and burden among pregnant women to justify its routine screening. Objectives: To investigate awareness, seroprevalence and risk factors for hepatitis C virus infection among pregnant women in Nigeria. Methods: A total of 159 pregnant women from antenatal clinics across six geopolitical zones in Nigeria consented to anti-hepatitis C virus testing which was confirmed using polymerase chain reaction technique. Confirmed hepatitis C virus positive women were further tested for hepatitis B and HIV. Participants were evaluated for risk factors for hepatitis C virus. Odds ratios, adjusted odds ratios, and their 95% confidence intervals (CIs) were determined, and p-values of <0.05 were considered significant. Results: Of 159 participants, 77 (48.4%; 95% confidence interval = 38.2%–60.5%) were aware of hepatitis C virus infection and awareness of hepatitis C virus was associated with young age (odds ratio = 2.21; 95% confidence interval = 1.16–4.21), high educational level (odds ratio = 3.29; 95% confidence interval = 1.63–6.64), and participants’ occupation (odds ratio = 0.51; 95% confidence interval = 0.26–0.99). In multivariable logistic regression, adjusted for confounders, the association between awareness of hepatitis C virus and participants’ young age (adjusted odds ratio = 1.60; 95% confidence interval = 1.09–2.35; p = 0.018) and high educational level (adjusted odds ratio = 1.48; 95% confidence interval = 1.17–1.86; p = 0.001) remained significant. Hepatitis C virus seroprevalence was found to be 1.3% (95% confidence interval = 0.2%–4.5%). All (100.0%, 95% confidence interval = 12.1%–100.0%) the hepatitis C virus-positive participants and 99 (63.1%, 95% confidence interval = 51.3%–76.8%) hepatitis C virus-negative participants had identifiable hepatitis C virus risk factors. Dual seropositivity of anti-hepatitis C virus/anti-HIV and anti-hepatitis C virus/hepatitis B surface antigen each accounted for 0.6%. The most identified risk factors were multiple sexual partners (15.7%), shared needles (13.8%), and blood transfusion (11.3%). There was no significant association between the risk factors and hepatitis C virus positive status. Conclusion: Awareness of hepatitis C virus infection among pregnant women in Nigeria is low and those aware are positively influenced by young age and high educational level. The prevalence of hepatitis C virus infection is high and provides preliminary evidence to justify antenatal routine screening.