Patterns of Testing in Children Exposed Perinatally Exposed to Hepatitis C

BACKGROUND: Kentucky (KY) has the Second highest rate of Hepatitis C (HCV) infections among pregnant women in the USA, largely due to IV drug use. HCV screening is recommended in children born to those women. HCV-exposed infants are also at risk for HIV and syphilis as well as neonatal abstinence syndrome (NAS). A substantial portion of HCV-exposed children are insured by Medicaid. The patterns of testing in this population are unknown. We sought to assess HCV-exposed children pattern of testing for HCV and other perinatal infections in children insured by KY Medicaid METHODS: We identified HCV-exposed infants (ICD-10-CM code Z20.5) insured by KY Medicaid from 10/1/15 to 9/30/16. The primary outcome was HCV testing by PCR [CPT 87520 (HCV, direct probe), 87521 (HCV, amplified probe), 87522 (HCV RNA, Quantitative)] or antibody (CPTs 86803-4). Testing for HIV (CPTs 86701, 86702, 87389, 87535), and syphilis (CPT 86592) was also recorded. NAS was defined as presence of ICD-10-CM code P96.1 in any diagnosis field. Descriptive statistics were used RESULTS: During the study period, 625 children with 4005 [median 3, Interquartile range (IQR) 1–8] claims were HCV-exposed. The majority of children were white (393, 63%), non-Hispanic (420, 67%) and male (318, 51%). Patterns of testing are shown in the Table. CONCLUSION: The proportion of HCV-exposed infants with a claim for HCV testing is low in the KY Medicaid population; testing for other perinatally-acquired infections is even less common. Children with NAS were less likely to be tested. Statewide guidelines for appropriate testing in children with perinatal HCV exposure and NAS are urgently needed. DISCLOSURES: C. Espinosa, Cempra: Investigator, Research grant. The Medicines company: Investigator, Research grant. Astrazeneca: Investigator, Research grant. Regeneron Pharmaceuticals, Inc.: Investigator, Research grant. Multiple Industry Sponsors (Merck, sanofi pasteur, Novartis, GlaxoSmithKline, Pfizer, Gllead: Sub investigator, lunch and Research support.