Epidemiology of Hepatitis C infection in pregnancy: Patterns and trends in West Virginia using statewide surveillance data

Abstract

Background

The increasing rate of Hepatitis C virus (HCV) infection has been attributed to the substance use epidemic. There is limited data on the current rates of the paralleling HCV epidemic.

Objectives

To estimate the prevalence of maternal HCV infection in West Virginia (WV) and identify contributing factors.

Methods

Population-based retrospective cohort study of all pregnant individual(s) who gave birth in WV between 01/01/2020 to 01/30/2024 (N = 69,925). Multiple log-binomial regression models were used to estimate the adjusted risk ratio (ARR) and the 95% confidence intervals (CI).

Results

The rate of maternal HCV infection was 38 per 1,000 deliveries. The mean age of pregnant individual(s) with HCV was 29.99 (SD 4.95). The risk of HCV was significantly higher in White vs. minority racial groups [ARR 1.93 (1.50, 2.49)], those with less than [ARR 1.57 (1.37, 1.79)] or at least high school [ARR 1.31 (1.17, 1.47)] vs. more than high school education, those on Medicaid [ARR 2.32 (1.99, 2.71)] vs. private health insurance, those residing in small-metro [ARR 1.32 (1.17, 1.48)] and medium-metro [ARR 1.41 (1.24, 1.61)], vs. rural areas, and those who smoked [ARR 3.51 (3.10, 3.97)]. HCV risk was highest for those using opioids [ARR 4.43 (3.95, 4.96)]; followed by stimulant use [ARR = 1.79 (1.57, 2.04)].

Conclusions

Our findings highlight that maternal age, race, education, and type of health insurance are associated with maternal HCV infection. The magnitude of association was highest for pregnant individual(s) who smoked and used opioids and stimulants during pregnancy in WV.

Keywords:

• Hepatitis C
• opioid-use disorder
• pregnancy
• substance use disorder
• injection drug use
• West Virginia

Ethics approval statement

The study was approved by West Virginia University’s IRB (Morgantown, West Virginia; Date of approval: Feb 27, 2023) # 2302731054.

Disclosure statement

The authors report no conflict of interest.

Role of funder

The West Virginia Department of Health had no role in the design and conduct of this study.

Data availability statement

The data are not publicly available due to the sensitive nature of the information that could compromise the privacy of research participants.

Additional information

Funding

The West Virginia Project WATCH is funded under an agreement with the West Virginia Department of Health, Bureau for Public Health, Office of Maternal, Child and Family Health. No funding was secured for this study.