Increases in Hepatitis C Threaten Young Women and Babies

The rate of women of childbearing age (WCBA) testing positive for hepatitis C increased by 22 percent across the United States between 2011 and 2014 (from 139 to 169 per 100,000 WCBA), according to a new report from the Centers for Disease Control and Prevention (CDC). Over the same time period, the national rate of infants born to women living with hepatitis C increased by 68 percent (from 0.19 percent to 0.32 percent).

CDC recommends that health care providers assess all pregnant women for risk factors associated with hepatitis C and test those who may be at risk. CDC also recommends testing for all children born to mothers living with hepatitis C. About six percent of these babies are infected with the virus during pregnancy or childbirth, and that risk doubles if a woman is co-infected with HIV or has high levels of hepatitis C virus in her body. No curative treatment has yet been determined safe for use by pregnant women or infants.

"Deaths from hepatitis C continue to increase -- it is the only nationally notifiable infectious disease with an upward trending death rate," said CDC Director Tom Frieden, M.D., M.P.H. "Undetected, untreated hepatitis C is a serious threat to a pregnant woman and to her child."

To evaluate the growing problem of hepatitis C infection among women of childbearing age (15 to 44 years old), as well as the potential for hepatitis C transmission between mother and child, researchers examined trends found in data from a nationwide commercial laboratory and in birth certificate data from the National Center for Health Statistics. Results appear in the Morbidity and Mortality Weekly Report (MMWR).

In addition to observing trends across the nation, researchers also examined state-specific data in Kentucky, the state with the highest incidence of new hepatitis C infections according to previously released surveillance data.

Between 2011 and 2014, the rate of hepatitis C detection among women of childbearing age more than tripled (from 275 to 862 per 100,000 WCBA) and the rate of infants born to women living with diagnosed hepatitis C increased 124 percent (from 0.71 percent to 1.59 percent) in the state.

"Women are screened throughout pregnancy for many conditions that threaten their health," said Jonathan Mermin, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. "An expectant mother at risk for hepatitis C deserves to be tested. Knowing her status is the only way she can access the best hepatitis care and treatment -- both for herself and her baby."

Hepatitis C kills. Recent CDC research revealed deaths associated with hepatitis C have reached an all-time high and have surpassed the total number of deaths from 60 other infectious diseases reported to CDC combined. About 3.5 million Americans are currently living with the virus.

Most of those infected are in the baby-boomer generation (born 1945 to 1965), but new infections are on the rise among young people who report injecting drugs. CDC recommends a one-time hepatitis C test for everyone born from 1945 to 1965 and regular testing for others at high risk. Once diagnosed, patients can take advantage of highly effective treatments that can cure the vast majority of infections in two to three months and take other steps to protect their health.

"The burden of new hepatitis C infections has shifted to a younger generation and is threatening to harm their children as well," said John Ward, M.D., director of CDC's Division of Viral Hepatitis. "We need to scale up efforts to prevent infection. Research is urgently needed to better understand whether the life-saving medicines that can cure hepatitis C are safe for pregnant women or could prevent mother-to-child transmission of the virus."

Partnerships with commercial laboratories complement data from state health departments and provide additional insights into disease trends. CDC is committed to helping communities use all effective tools to stop the spread of hepatitis C and reduce deaths associated with the disease. Addressing viral hepatitis risk among people who inject drugs is a key concern for CDC.

CDC recommends starting comprehensive prevention programs that include regular testing for hepatitis C (as well as for hepatitis B and HIV); rapid links to medical care for those who test positive; and access to substance abuse treatment, sterile injection equipment, and other services. Through collaborative efforts, we can help reduce the rise in new infections and reverse trends in hepatitis C-related mortality, ultimately ensuring that far fewer people die of this disease.