HCV pregnancy increase suggests need for broader screening

 

Hepatitis C virus (HCV) infection among women giving birth increased 89% from 1.8 cases per 1,000 live births in 2009 to 3.4 cases in 2014, translating to about 35 infants exposed to the virus per day in the United States in 2014, according to the May 11 Morbidity and Mortality Weekly Report.

The highest rate in 2014 was in West Virginia, with 22.6 cases per 1,000 live births. The lowest was in Hawaii, with 0.7 cases.

In adjusted analyses of Tennessee births, residence in a rural county – a county with less than 50,000 residents – increased the odds of maternal HCV infection more than threefold, smoking during pregnancy increased the odds more than fourfold, and concurrent hepatitis B virus infection increased the odds almost 17-fold.

“The prevalence of maternal HCV infection appears to have increased sharply in the United States. ... Ensuring that women of childbearing age have access to HCV testing and treatment and consideration of universal screening among women of reproductive age residing in areas with high HCV prevalence might mitigate risk and prevent transmission,” said investigators led by Stephen Patrick, MD, of the division of neonatology at Vanderbilt University, Nashville (MMWR. 2017;66[18]:470-3).

Both the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists recommend selective screening of pregnant women at high risk for HCV infection, including intravenous drug users and long-term hemodialysis patients.

“These data might inform expansion of the definition of women at risk.” Generally, about 6% of infants will pick up HCV from their mother during delivery. Screening and treating women of childbearing could reduce the risk, the investigators said.

The analysis was based on U.S. birth certificate data. Risk factors were identified using Tennessee birth certificates.

[email protected]

 

Hepatitis C virus (HCV) infection among women giving birth increased 89% from 1.8 cases per 1,000 live births in 2009 to 3.4 cases in 2014, translating to about 35 infants exposed to the virus per day in the United States in 2014, according to the May 11 Morbidity and Mortality Weekly Report.

The highest rate in 2014 was in West Virginia, with 22.6 cases per 1,000 live births. The lowest was in Hawaii, with 0.7 cases.

In adjusted analyses of Tennessee births, residence in a rural county – a county with less than 50,000 residents – increased the odds of maternal HCV infection more than threefold, smoking during pregnancy increased the odds more than fourfold, and concurrent hepatitis B virus infection increased the odds almost 17-fold.

“The prevalence of maternal HCV infection appears to have increased sharply in the United States. ... Ensuring that women of childbearing age have access to HCV testing and treatment and consideration of universal screening among women of reproductive age residing in areas with high HCV prevalence might mitigate risk and prevent transmission,” said investigators led by Stephen Patrick, MD, of the division of neonatology at Vanderbilt University, Nashville (MMWR. 2017;66[18]:470-3).

Both the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists recommend selective screening of pregnant women at high risk for HCV infection, including intravenous drug users and long-term hemodialysis patients.

“These data might inform expansion of the definition of women at risk.” Generally, about 6% of infants will pick up HCV from their mother during delivery. Screening and treating women of childbearing could reduce the risk, the investigators said.

The analysis was based on U.S. birth certificate data. Risk factors were identified using Tennessee birth certificates.

[email protected]

 

Hepatitis C virus (HCV) infection among women giving birth increased 89% from 1.8 cases per 1,000 live births in 2009 to 3.4 cases in 2014, translating to about 35 infants exposed to the virus per day in the United States in 2014, according to the May 11 Morbidity and Mortality Weekly Report.

The highest rate in 2014 was in West Virginia, with 22.6 cases per 1,000 live births. The lowest was in Hawaii, with 0.7 cases.

In adjusted analyses of Tennessee births, residence in a rural county – a county with less than 50,000 residents – increased the odds of maternal HCV infection more than threefold, smoking during pregnancy increased the odds more than fourfold, and concurrent hepatitis B virus infection increased the odds almost 17-fold.

“The prevalence of maternal HCV infection appears to have increased sharply in the United States. ... Ensuring that women of childbearing age have access to HCV testing and treatment and consideration of universal screening among women of reproductive age residing in areas with high HCV prevalence might mitigate risk and prevent transmission,” said investigators led by Stephen Patrick, MD, of the division of neonatology at Vanderbilt University, Nashville (MMWR. 2017;66[18]:470-3).

Both the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists recommend selective screening of pregnant women at high risk for HCV infection, including intravenous drug users and long-term hemodialysis patients.

“These data might inform expansion of the definition of women at risk.” Generally, about 6% of infants will pick up HCV from their mother during delivery. Screening and treating women of childbearing could reduce the risk, the investigators said.

The analysis was based on U.S. birth certificate data. Risk factors were identified using Tennessee birth certificates.

[email protected]