• Population-based study of 1202 pregnant women in Paraná, Brazil. • Anti-HCV antibody seroprevalence was 0.75%, with no active infections detected. • Over half of seropositive women were unaware of prior HCV exposure. • Findings support universal prenatal HCV screening as a postpartum care opportunity, even in low-prevalence settings. • Regional heterogeneity underscores the need for equitable screening policies in Brazil. Hepatitis C (HCV) is an important cause of global morbidity and mortality and can progress to cirrhosis and hepatocellular carcinoma. Vertical transmission occurs in around 5%‒6% of cases, increasing in pregnant women with a high viral load or co-infection with HIV. Although universal screening is recommended by international guidelines, its implementation in Brazil is uneven. This study estimated the seroprevalence of anti-HCV antibodies among pregnant women attending public maternity hospitals in Paraná and compared the results with national data. This was an observational, descriptive, and cross-sectional population-based study to assess seroprevalence. The study included 1202 pregnant women aged between 16 and 49, treated in 14 public maternity hospitals in Paraná, in different regions of the state. Anti-HCV screening was carried out by ELISA, and reactive cases were confirmed by viral load (PCR). Sociodemographic and obstetric data and risk factors were obtained from questionnaires and medical records. Nine participants tested positive for anti-HCV antibodies, corresponding to a seroprevalence of 0.75% (95% CI 0.34%‒1.40%). This seroprevalence falls within the range reported in previous Brazilian cross-sectional studies of pregnant women (0.06%–2.66%). No active infection was identified, as all reactive samples were HCV RNA-negative. More than half were unaware of their previous infection. No significant associations with traditional risk factors were observed. The low anti-HCV seroprevalence and the absence of detectable viremia indicate a minimal risk of vertical transmission in the cohort studied. These findings are consistent with low endemicity settings and support the role of prenatal screening in identifying previously undiagnosed infection and enabling linkage to postpartum care. The studies reviewed showed substantial heterogeneity in prevalence estimates, reflecting differences in population characteristics, sample sizes, study periods, and methodologies. The under-representation of rural areas and the exclusion of illiterate women may have led to an underestimation of seroprevalence and should be considered when interpreting the results. Therefore, the findings are primarily generalizable to literate pregnant women attending public maternity hospitals in urban and peri‑urban áreas.
Aquery et al. (Thu,) studied this question.