CDC: HCV prevalence at delivery spikes, opioid use a factor

  • MMWR Morb Mortal Wkly Rep
  • 04/10/2019

  • Yael Waknine
  • Clinical Essentials
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Takeaway

  • HCV prevalence among women giving birth increased more than 400% from 2000 to 2015.
  • Infection rates were significantly higher among women with opioid use disorder (OUD).

Why this matters

  • Findings support an association with the opioid crisis and surge in injection drug use.
  • OUD treatment should include HCV screening, referral.

Study design

  • CDC analysis of hospital discharge data from the 2000-2015 Healthcare Cost and Utilization Project.
  • Funding: None disclosed.    

Key results

  • National prevalence of HCV infection rose >400% (0.8 to 4.1 per 1000 deliveries).
    • Rates rose 15.7% during 2000-2004 (P<.001 from to and during>
  • OUD: HCV prevalence rose 148% (87.4 to 216.9 per 1000 deliveries).
    • Rate increased 17.2% from 2000 to 2004 (P<.001 remained stable during and increased>
  • Non-OUD: HCV prevalence was lower but rose 271% (0.7 to 2.6 per 1000 deliveries).
    • Rate remained stable during 2000-2002 (21.1%; P=.1) and increased 5.5% and 15.0% during 2002-2011 and 2011-2015 (both P<.001>
  • Women aged 25-34 vs ≥35 years were more likely (OR, 95% CI) to have HCV (1.2; 1.0-1.4), OUD (1.8; 1.6-2.0), or both (1.8; 1.4-2.3) at delivery.
    • Additional factors included Medicaid/Medicare, native American status, white race, and residence in low-income areas, the South, or the Northeast.

Limitations

  • Observational design.