HCV Spikes In Pregnant Wisconsin Women

A new state-level analysis out of Wisconsin shows that the rate of hepatitis C (HCV) infection among pregnant women increased sharply from 2011 to 2015.

The rise in HCV infection is believed to be fueled at least in part by an increase in opioid abuse.

The study was based on HCV infection data for women receiving Medicaid in the State of Wisconsin. It tracked infection rates over the 4-year period, during which the rate of pregnant women on Medicaid who showed signs of HCV infection jumped from 1 in 368 pregnancies to 1 in 192 — an increase of 93%.

The study also found that among infants born to women with signs of HCV infection, about 4% of babies were infected. However, only 34% of babies whose mothers showed signs of infection were actually tested for the virus. Thus, it’s unclear how high the rate of infection among babies might actually be.

Study author Theresa Watts (pictured), RN, MPH, told MD Magazine that the research illuminates a gap in HCV screening and testing.

“Practices for screening pregnant women for HCV and babies born to HCV-infected mothers should be improved to prevent serious but preventable complications among mothers and babies,” Watts said.

Watts, a third-year PhD student in nursing at the University of Wisconsin-Madison, partnered with the state’s Department of Health Services to conduct the research. Watt’s area of focus is HCV risk, testing, and treatment among women of reproductive age. However, the data has a number of insights that could be helpful as policymakers consider how to respond to the growing opioid abuse problem.

That’s because, while opioid abuse isn’t directly linked to HCV transmission, the 2 can affect similar populations.

According to the National Institute on Drug Abuse, nonmedical opioid use is a major risk factor for heroin use. Use of heroin was 19 times higher for people who reported using prescription opioids for nonmedical purposes versus the general population, according to data from 2002 to 2012.

Injection drug use, in turn, is the most common means of HCV transmission in the United States, according to the US Centers for Disease Control and Prevention (CDC). Birth to an HCV-infected parent is another major risk factor.

Watts noted that the Wisconsin data set only covered the years of 2011 through 2015, so it’s impossible to know whether the trends in HCV infection rates have continued since 2015 as the opioid issue has escalated to a public health emergency. However, by 2015, federal government data already showed that nationally, about 2 million people were abusing opioids.

Regardless of the cause of infection among pregnant women, Watts said the risk to infants, specifically, could be addressed through better screening of women before they get pregnant.

“By testing, treating, and curing HCV infections among women of childbearing age before they become pregnant, providers can prevent putting babies at risk for illness,” Watts said.

The research was published in the CDC’s Oct. 27 Morbidity and Mortality Weekly Report, and is available at this link.

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