Hepatitis C Rates Increase Among Women of Child-Bearing Age

A new study found increased rates of hepatitis C virus (HCV) detection among women of childbearing age between 2011 and 2014, with a potential risk for mother-to-child (vertical) transmission.

In the study conducted by the US Centers for Disease Control and Prevention (CDC), researchers examined trends in HCV detection among women of childbearing age, HCV testing among children aged ≤2 years, and the proportion of infants born to mothers with HCV nationally and in Kentucky, which had the highest incidence of acute HCV infection during the study period.

The results of the study showed that during this time period, national rates of HCV detection increased 22% among women of childbearing age. HCV testing among children aged ≤2 years increased 14%, while birth certificate data indicated that the proportion of infants born to mothers infected with HCV increased 68%, from 0.19% to 0.32%.

From 2011 to 2014 in Kentucky, the HCV detection rate increased >200% among women of childbearing age, HCV testing among children increased 151%, and the proportion of infants born to women infected with HCV increased 124%, from 0.71% to 1.59%.

The findings suggest a potential risk for vertical transmission of HCV. The authors noted that the findings highlight the importance of following the current CDC recommendations to identify, counsel, and test people at risk of HCV infection.

Currently, many states do not mandate the reporting of all HCV cases, resulting in a substantial amount of HCV-positive women of childbearing age, including pregnant women, who are unlikely reported in routine state-based surveillance systems.

Limitations to the study include: incomplete information on pregnancy status on case report forms used for surveillance in Kentucky; maternal HCV infection status on birth certificates might underestimate rates of infants born to mothers infected with HCV; identifying cases of people infected with HCV, including pregnant women, relies on completeness of reporting; laboratory data was limited to a single commercial laboratory and may not represent Kentucky and US populations; HCV-positive mothers cannot be linked to their children using laboratory data; and information on children’s age in laboratory data is limited, making it difficult to determine whether children are appropriately tested and have current infection.

The authors noted that the findings underscore the importance of having primary prevention services. The authors also urged following current CDC recommendations to help identify individuals at risk of HCV infection, and to test accordingly.

For pregnant women, this could improve early identification of HCV-infected infants, leading to care and treatment. For women of childbearing age, this could link them to care, treatment, and a potential cure, to avoid mother-to-child transmission in the future.