Rates of the viral disease hepatitis C have risen sharply in recent years, nearly doubling in pregnant women, according to a new report published by the U.S. Centers for Disease Control and Prevention.
Rates of maternal hepatitis C infection increased 89 percent from 1.8 to 3.4 women per 1,000 live births, according to the study published in the CDC's Morbidity and Mortality Weekly Report. Certain states reported particularly high rates of infants born to mothers who test positive for the viral disease.
In West Virginia, where the ongoing opioid epidemic has hit hard, the infection rate was 22.6 women per 1,000 live births. In Tennessee, the rate was 10.1 women per 1,000 births
Dr. Stephen Patrick, lead author on the study and a neonatoloigst at Vanderbilt University Medical Center, said the study findings point to an "emerging public health issue."
"The worry is that with our current system [patients] don't know they're infected and our systems that follow infants are pretty poor," he said. Since hepatitis C often doesn't cause symptoms for years, Patrick said patients may not seek supportive medical care or may spread the disease without realizing it.
Patrick and the other researchers reviewed data from birth certificates from the National Vital Statistics System between 2009 and 2014 and the Tennessee Department of Heath vital records. The national data was used to study overall rates of hepatisis C infections in pregnant women and the Tennessee data was used to examine individual characteristics and outcomes associated with the infection.
The Hepatitis C Virus (HCV) is a blood-borne infection that can cause chronic inflammation of the liver.
While the disease is more common in the baby boomer population, Patrick said the new infections have increased among women in their reproductive years revealing one new effect of the opioid epidemic. The viral disease can be easily transmitted if people share needles and via sexual contact.
He pointed out that rural areas where the opioid epidemic had been centered have now been hit particularly hard by the increasing hepatitis C rates.
"We found that some counties -- particularly rural counties in Tennessee -- where eight percent of infants were exposed to hepatitis C," said Patrick. The infants were exposed to the virus by being born to mothers who tested positive for the disease.
In one West Virginia county, one out of every 50 births involved a woman who tested positive for hepatitis C, Patrick said.
Patrick said he hoped the findings may lead to additional screening for pregnant women, especially if they live in areas with high levels of opioid abuse. He also called for more assistance to get these women into treatment and to better understand opioid addiction to treat these patients.
"It continues to call for public health approach," Patrick said.
While there are medications that can resolve hepatitis C infections, they are not approved for pregnant women or children at this point.
The study joins other evidence pointing to the devastating effects of opioid abuse on hepatitis C rates. In a preliminary study released by the CDC today, rates of hepatitis C infection that were reported reached a 15-year high.
The annual numbers of hepatitis C reported to the CDC have nearly tripled, rising from 850 in 2010 to 2,436 in 2015. CDC researchers estimate this is likely just a fraction of the true numbers, since many people may not know they are infected. They estimate 34,000 new hepatitis C infections occurred in 2015 alone.
"By testing, curing and preventing hepatitis C, we can protect generations of Americans from needless suffering and death," said Dr. Jonathan Mermin, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention in a statement released today. "We must reach the hardest-hit communities with a range of prevention and treatment services that can diagnose people with hepatitis C and link them to treatment."
The CDC said the data show the increase was primarily a result of intravenous drug use.