Hepatitis C rates soar among pregnant women

By Alan Mozes Health Day Reporter

FRIDAY, July 21, 2023 (HealthDay News) — In the two decades since the opioid epidemic began, the addiction crisis has claimed the lives of hundreds of thousands of Americans.

Now, new research points to another grim consequence of the crisis on American health: a skyrocketing risk in pregnant women of hepatitis infection (HCV).

This is because the main risk factor for contracting hepatitis C – a liver infection transmitted through contact with blood – is injection drug use.

Between 1998 and 2018, the prevalence of HCV in pregnant women increased 16-fold, the researchers found, increasing the risk of poor fetal development and fetal distress, as well as premature birth.

And this is just an overview among pregnant women of all ages. Among those between the ages of 21 and 30, the risk of hepatitis C soared by more than 3000%.

“We believe the increase in HCV infections among pregnant women in our data is concerning,” noted the lead author. Dr. Po-Hung (Victor) ChenAssistant Professor of Medicine at the Comprehensive Transplant Center at Johns Hopkins University School of Medicine in Baltimore.

On the contrary, he says, the concern should be even greater than the number cited in the study might suggest, given that US obstetricians did not routinely screen all pregnant women for HCV during the study period.

“Therefore, our results likely even underestimated the true number of HCV infections among pregnant women in the United States,” Chen added.

Hepatitis C is the most commonly reported chronic blood-borne infection in the United States, researchers said.

Usually, she has no symptoms until liver disease sets in. Without timely screening and diagnosis, untreated hepatitis C can lead to liver inflammation, cirrhosis and cancer.

Chen said the link to the opioid crisis stems from sharing needles and syringes, since HCV is transmitted through blood.

Between 1999 and 2020, more than 564,000 people died from an opioid overdose, according to the US Centers for Disease Control and Prevention.

For this study, Chen’s team looked at data from more than 70 million women between the ages of 18 and 50 who were hospitalized between 1998 and 2018 for childbirth or following a miscarriage.

Just over 137,000 have tested positive for hepatitis C.

About three-quarters of infected women were Caucasian, and about two-thirds were under 31. Nearly 3 in 10 reported using opioids.

By the final year of the study period, researchers found that 5.8 out of 1,000 pregnant women were HCV-positive, a 16-fold increase.

During this two-decade period, pregnant women between the ages of 41 and 50 also saw their risk of hepatitis C increase by 300%.

The risk of HCV among the largest group of women – those aged 21 to 30 – increased much more dramatically, increasing 31 times (or about 3100%).

“These weren’t just risks or assumptions,” Chen pointed out, but actual numbers seen in American women.

While suggesting that the evidence for a link between the opioid epidemic and HCV is “compelling”, Chen conceded that this study does not definitively prove that the opioid crisis directly caused the increase in HCV seen in pregnant women.

But he added that it indicates that universal HCV screening in every pregnancy makes sense.

“However,” Chen added, “testing is only the first step. We need more research on best practices for connecting mothers and their infants who test positive for HCV with specialists who can help them.”

Dr David Bernstein is a professor at NYU Grossman School of Medicine and the new Director of Ambulatory Gastroenterology and Hepatology at NYU Langone Long Island in New York City.

He said the results were no surprise.

“We have seen evidence of large increases in hepatitis C prevalence among young women and men due to the opioid crisis in this country,” Bernstein noted. “And since we’re not adequately addressing the opioid crisis, we’re going to continue to see young women getting pregnant who have hepatitis C. And that’s going to put their child at risk of acquiring it at birth.”

Bernstein noted that between 3% and 5% of infants born to an HCV-infected mother will have the disease themselves.

The good news: “Once identified, hepatitis C is treatable and curable in more than 95% of those infected,” he added.

Even so, Bernstein pointed out that the study highlights something everyone in the field knows: to address risks like HCV, “far more resources” need to be invested in tackling the opioid crisis.

“The crisis is only getting worse,” he said. ” And that’s a shame. Because this stuff is 100% preventable.

The United States Centers for Disease Control and Prevention know more about Hepatitis C.

SOURCE: Po-Hung (Victor) Chen, MD, PhD, assistant professor, medicine, division of gastroenterology and hepatology, Comprehensive Transplant Center-Liver Transplant, Johns Hopkins University School of Medicine, Baltimore; David Bernstein, MD, professor of medicine, NYU Grossman School of Medicine, and director, outpatient gastroenterology and hepatology, NYU Langone Long Island, New York; Open JAMA NetworkJuly 21, 2023

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