Mother-to-infant HCV transmission risk on the rise in Wisconsin

The proportion of pregnant women with hepatitis C virus infection who receive Medicaid in Wisconsin has risen dramatically, suggesting an increased risk for mother-to-infant transmission, according to an MMWR.

As HCV infection among women of child-bearing age increases both in the Midwest state and nationally, clinicians must step up diagnostics and surveillance, researchers wrote in the report.

“Enhanced identification through HCV screening during pregnancy and public health follow-up to monitor infants at risk for vertical transmission are needed,” Theresa Watts, MPH, of the University of Wisconsin School of Nursing, and colleagues said.

To assess the risk for vertical HCV transmission in Wisconsin, the researchers examined data from reports of infection in the Wisconsin Electronic Disease Surveillance System and childbirths among women on Medicaid in Wisconsin between 2011 and 2015.

During that period, HCV infection among pregnant women increased by 93% — from one in 368 pregnancies to one in 192. Out of 183 children born to women with evidence of HCV viremia, 34% were tested for the virus as recommended, the researchers said, and vertical transmission was reported in 4% of infants.

Watts and colleagues also cited prior research showing that, nationwide, one in 308 infants were born to women with HCV in 2014. The findings from Wisconsin and the United States as a whole call for improved surveillance, the researchers said.

They recommended following a recent position statement on notification of HCV vertical transmission issued by the Council of State and Territorial Epidemiologists. The statement, in part, recommends that all U.S. states and territories make it a notifiable condition.

“Adoption of this position statement by state and local health departments, along with enhanced identification of HCV among women of childbearing age, can improve care for HCV-infected women and infants at risk for HCV vertical transmission,” Watts and colleagues wrote. – by Joe Green

References:

Council of State and Territorial Epidemiologists. Public Health Reporting and National Notification of Perinatal Hepatitis C Virus Infection. http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/2017PS/2017PSFinal/17-ID-08.pdf. 2017. Accessed October 26, 2017.

Watts T, et al. MMWR Morb Mortal Wkly Rep. 2017;10.15585/mmwr.mm6642a3.

Disclosures: The authors report no relevant financial disclosures.