October 11, 2022

Universal Hepatitis C Screening among Pregnant Persons: The Time is Now

Hepatitis C is the most commonly reported blood-borne infection in the US, responsible for more deaths than all 60 reportable infectious diseases combined. Once most prevalent among “Baby Boomers” or those born between 1945 and 1965, the current hepatitis C burden disproportionately affects young adults who inject drugs, including women of childbearing age. Because of this epidemiological shift, perinatal transmission – which happens when a pregnant person living with hepatitis C passes it to their baby either within the uterus or during labor – is also on the rise. Approximately 6% of infants born to people with hepatitis C will become infected.

Given the increased prevalence of hepatitis C among women of childbearing age, more people with hepatitis C will become pregnant and for many of them, obstetric care will be their primary encounter with the health system. Hepatitis C screening during pregnancy presents an opportunity for early identification as well as dialogue between pregnant people and their clinicians about transmission and risk. In a sense, pregnancy presents an ideal opportunity to diagnose hepatitis C among pregnant people, link them to care and refer them to treatment. Tackling hepatitis C among women, and during pregnancy in particular, is critical to achieving the New York State Hepatitis C Elimination Plan’s goal to eliminate hepatitis C as a public health problem in the state by 2030.

Resources

  • New York State Department of Health AIDS Institute guideline for treatment of chronic HCV with direct-acting antivirals, Pregnancy and HCV: https://www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4
  • New York State Department of Health AIDS Institute guideline for substance use disorder treatment in pregnant adults: https://www.hivguidelines.org/substance-use/sud-treatment-pregnancy/
  • The American College of Obstetricians and Gynecologists Routine Hepatitis C Virus Screening in Pregnant Individuals Practice Advisory: https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/05/routine-hepatitis-c-virus-screening-in-pregnant-individuals
  • Godar, E.A., & Jhaveri, R. (2021). A survey of practices in the United States regarding hepatitis C screening in pregnant women. Clin Ther, 43(3):780-784. doi: 10.1016/j.clinthera.2021.01.016
  • Kushner, T., Chappell, C.A., & Kim, A.Y. (2019). Testing for hepatitis C in pregnancy: the time has come for routine rather than risk-based. Curr Hepatol Rep,18(2):206-215. doi: 10.1007/s11901-019-00468-y
  • Kushner, T. & Reau, N. (2021). Changing epidemiology, implications, and recommendations for hepatitis C in women of childbearing age and during pregnancy. Jour of Hepatol, 74(3):734-741. doi: 10.1016/j.jhep.2020.11.027
  • Ly, K.N., Jiles, R.B., Teshale, E.H., Foster, M.A., Pesano, R.L., & Holmberg, S.D. (2017). Virus infection among reproductive-aged women and children in the United States, 2006-2014. Ann Intern Med, 166(11):775-782. doi: 10.7326/M16-2350

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