Since the opioid epidemic began two decades ago, hepatitis C virus (HCV) rates have been on the rise—especially in pregnant women, according to new research.

It’s estimated that 2.4 million Americans were living with chronic HCV between 2013 and 2016 (about 1% of the adult population), according to the Centers for Disease Control and Prevention. What’s more, 14,242 people died of HCV in 2019, and acute HCV cases quadrupled from 2009 to 2019.

As described in JAMA Network Open, the researchers found that from 1998 to 2018, the prevalence of HCV among pregnant women of all ages increased 16-fold, which in turn increases the risk for poor fetal development, preterm birth and fetal distress, which occurs when the baby does not receive enough oxygen through the placenta during pregnancy or labor. What’s more, during this time, HCV among pregnant women ages 21 to 30 increased more than 3000%, according to a U.S. News & World Report article.

“We do think the increase in HCV infections among pregnant women in our data is concerning,” lead author Po-Hung (Victor) Chen, MD, an assistant professor of medicine at Johns Hopkins University School of Medicine’s Comprehensive Transplant Center, said in the article.

Chen added that the number cited in the study may misrepresent the reality of the situation as many obstetricians in the United States were not routinely screening all pregnant women for HCV during the study period. “Therefore our findings likely even underestimated the true number of HCV infections among pregnant women in the U.S.,” Chen said.

Women who are infected with HCV have a 6% chance of passing the virus along to their babies during pregnancy or delivery. The risk increases significantly if the woman has HIV, hepatitis B or a high HCV viral load (the amount of HCV in a measurement of blood). The HCV transmission risk is doubled or tripled in women with HIV. It is unlikely that hep C can be transmitted through breastfeeding or breast milk, according to Hep Mag’s Health Basics on HCV.

The study examined date from more than 70 million women between 18 and 50 years old who were hospitalized to give birth or as a result of a miscarriage between 1998 and 2018. Just over 137,000 women tested positive for HCV. Of that group, about three-quarters were white, about two-thirds were under 31 and nearly three in 10 reported opioid use.

During the last year of the study period, 5.8 of every 1,000 pregnant women had HCV—a 16-fold increase. Pregnant women between 41 and 50 years old experienced a 300% rise in HCV risk. Pregnant women between 21 and 30 years had a 31-fold increase in HCV risk.

As HCV is spread via blood, the potential link to the opioid crisis stems from sharing needles and syringes. Chen said, however, that the opioid crisis may not be the direct cause of the increased risk of HCV observed during the study period. Yet, he noted that the increase should urge health care professionals to begin universal HCV screening in pregnant women.

"Screening is just the first step,” he said. “We need additional research on best practices for connecting mothers and their infants who screened positive for HCV to specialists who can help them.”

To read more, click #Pregnancy. There, you’ll find headlines such as “Only 41% of Pregnant People Were Screened for Hepatitis C in 2021,” “Early Viread and Infant Vaccination Prevents Mother-to-Child Transmission of Hepatitis B” and “Hepatitis C During Pregnancy Linked to Worse Outcomes.”