High Rates of Hepatitis C in Pregnancy Mirror Opioid Epidemic: CDC

Rural counties seem hardest hit, researcher says

By Margaret Farley Steele

Thursday, May 11, 2017

THURSDAY, May 11, 2017 (HealthDay News) -- Chalk up another potential consequence of the U.S. opioid epidemic: The prevalence of hepatitis C infections among pregnant women nearly doubled between 2009 and 2014, U.S. health officials report.

Hepatitis C -- which is caused most often by injection drug use -- rose 89 percent nationwide among pregnant women. Increases were most notable in West Virginia and rural counties in Tennessee, areas hard-hit by the heroin and prescription painkiller epidemic, the U.S. Centers for Disease Control and Prevention reported.

Nationwide, 35 infants a day were exposed to the contagious liver disease, on average, study authors said.

"We have seen a dramatic increase in opioid use in pregnancy and in the number of infants having drug withdrawal," said report author Dr. Stephen Patrick, of Vanderbilt University Medical Center in Nashville.

"Taken together, this suggests that efforts targeted at preventing and expanding treatment for opioid use disorder may help mitigate some of the increases we see," Patrick said in a Vanderbilt news release. He's an assistant professor of pediatrics and health policy.

In West Virginia, the study found that more than 1 in 50 newborns was exposed to hepatitis C at the time of childbirth, researchers said.

In Tennessee, about 1 in 100 babies were exposed during delivery to the virus. Rates were three times as high in rural areas of the state compared to urban counties, according to the study.

Nationwide, the hepatitis C infection rate among mothers-to-be was slightly more than 1 per 300 live births in 2014, the study revealed.

Regions hardest hit by opioid overdose deaths were also most likely to see jumps in hepatitis C, the report noted.

The findings indicate that women of childbearing age need access to hepatitis C testing and treatment, said study senior author Dr. Carolyn Wester. She's the medical director for HIV, sexually transmitted diseases and viral hepatitis at the Tennessee Department of Health.

Treating the virus before a woman becomes pregnant is critically important, Patrick said. He added that it's also imperative to follow infants exposed to hepatitis C in the womb in case they develop the virus.

"We need to build systems of care to ensure that all infants exposed to the virus are adequately followed," Patrick said.

Hepatitis C, the most common bloodborne infection in the United States, affects an estimated 3.5 million Americans, the CDC said.

The study reviewed birth records from 2009 to 2014. Researchers found wide variations in hepatitis C prevalence at delivery. The researchers also looked at specific health and lifestyle factors for expectant mothers in Tennessee.

"We found that rural and Appalachian counties were particularly impacted by the virus," Patrick said. "In some counties in Tennessee, nearly 8 percent of pregnant women were documented as being infected with hepatitis C at the time of delivery."

Besides living in rural areas, moms with hepatitis C were more likely to be single and to smoke than others. They also were less likely to have any college education or adequate prenatal care, the study found.

The study was published May 11 in the CDC's Morbidity and Mortality Weekly Report.

SOURCES: U.S. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, May 12, 2017; Vanderbilt University, news release, May 11, 2017

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