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Hepatitis C Screening in Mothers and Infants Exposed to Opioids

Rebecca Bell1, Isabel Wolfe2, David Cox3

  • 1School of Medicine, Tufts University, Boston, Massachusetts; rebecca.bell@tufts.edu.

Hospital Pediatrics
|July 12, 2019
PubMed

Insights

Hepatitis C virus (HCV) screening increased among mothers with opioid use, but testing and diagnosis rates for infants remain low. Improved care is needed for these high-risk infants born to mothers with opioid use disorder.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Neonatal Care

Background:

  • Hepatitis C virus (HCV) is a significant blood-borne pathogen, with rising prevalence linked to the opioid epidemic.
  • Perinatal opioid use has increased, leading to a higher risk of HCV transmission from mothers to infants.
  • National guidelines recommend universal HCV screening for pregnant women and infants exposed in utero.

Purpose of the Study:

  • To analyze trends in HCV prevalence and screening among mothers with opioid use during pregnancy.
  • To assess HCV screening and positivity rates in infants exposed to HCV in utero.

Main Methods:

  • Retrospective cohort analysis of infants with neonatal abstinence syndrome and in-utero opioid exposure (2013-2018).
  • Data extracted from electronic medical records and a statewide laboratory database (HealthInfoNet).
  • Included maternal and infant HCV screening status, demographics, and follow-up care.

Main Results:

  • 769 infants with in-utero opioid exposure were identified.
  • Maternal HCV screening rose from 58.1% (2013) to 90% (2018); 47.9% of screened mothers were HCV-positive.
  • Of 177 eligible infants, 53% were tested for HCV, with 7.4% testing positive; an estimated 10 additional infants were undiagnosed.

Conclusions:

  • Maternal and infant HCV screening rates remain suboptimal despite high HCV prevalence in this population.
  • There is a critical need for enhanced care strategies for infants born to mothers with opioid use disorder and HCV exposure.
  • Early diagnosis and treatment are crucial to prevent long-term complications of HCV in exposed infants.
Abstract

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