The prevalence of hepatitis C virus (HCV) among pregnant women with substance use disorders is high, and better strategies to effectively screen and link women and their exposed infants to HCV care and treatment are needed, according to a study published in the Journal of Pediatrics.1
One of the goals of the US Department of Health and Human Services National Viral Hepatitis Action Plan is to eliminate mother-to-infant transmission of HCV infection.2 The prenatal care setting is ideal for identifying infected women and linking them to care for disease staging and treatment after pregnancy, as well as alerting providers to appropriately evaluate her child for HCV infection.3
Researchers analyzed electronic health records from an obstetric clinic of a 10-year cohort of 879 women with opioid use disorder and found that of these women, 744 were screened for HCV and 510 (68%) were found to be seropositive.1 Four hundred four infants were born to HCV-seropositive women, and of these, only 273 (68%) were tested at least once for HCV, 180 (45%) completed the American Academy of Pediatrics recommended perinatal HCV screening, and 5 (2.8%) were diagnosed with HCV infection and linked to care. Women who had greater linkage to HCV care included those who delivered in more recent years (2014-2015) and infants born to mothers who had a coinfection with HIV and methadone maintenance therapy.
The investigators concluded that, “HCV prevalence among pregnant women with opioid use is high and infant HCV screening is imperfect.”1 Further research is needed to improve both mother and infant follow-up to help bridge the gaps in the cascade to cure.
- Epstein RL, Sabharwal V, Wachman EM, et al. Perinatal transmission of hepatitis C virus: defining the cascade of care [published online August 28, 2018]. J Pediatr. doi: 10.1016/j.jpeds.2018.07.006
- U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health. National viral hepatitis action plan (2017-2020). Accessed June 5, 2017.
- The American Congress of Obstetricians and Gynecologists (ACOG). Obstetrician-gynecologists are primary care physicians. ACOG Fact Sheet. Washington, DC: ACOG; 2015.