Study Shows Disparities in Hepatitis C Treatment among Reproductive-Aged Women

Most pediatric cases of Hepatitis C Virus (HCV) infection occur perinatally, meaning the virus is passed from mother to child during gestation or birth, according to the Centers for Disease Control and Prevention. If left untreated, HCV infections can lead to chronic liver disease, liver failure and cancer later in life – so identifying disparities in testing and treating Hepatitis C among reproductive aged women who use opioids could improve health outcomes for all birthing parents and their offspring.

Researchers from BMC conducted an investigation of racial and ethnic disparities using national data on care of Hepatitis C for reproductive-aged women with opioid use disorder and published their findings in Clinical Infectious Diseases.

Screening and treating Hepatitis C in reproductive-aged women can be an invaluable way of breaking the cycle of transmission. Early identification and treatment will significantly decrease disease risks while protecting children against further transmission; ultimately improving both maternal and infant health outcomes.”
Rachel Epstein, MD, MScE is the lead author on this paper and an infectious disease clinician-scientist at Boston Medical Center (BMC).

Asian and Black individuals were found to be 25% less likely than white individuals to get tested for Hepatitis C virus; American Indian/Alaska Native women were tested more than any other group and less than 10% of women with opioid use disorder who tested positive received treatment; it may be beneficial to identify and treat all reproductive-aged women so as to lower risks associated with poor health outcomes both for themselves and their offspring.

Testing people means connecting them with care, which in turn leads to serious ramifications such as transmitting the virus. Treating postpartum and pregnant women for Hepatitis C infections – with appropriate discussion about risks and benefits prior to treating – is vitally important to improving overall health outcomes for everyone.” As noted by Breanne Biondi MPH PhD Candidate of Boston University School of Public Health.

At BMC, clinicians are taking proactive steps to reduce disparities in hepatitis C care. Project RESPECT piloted an initiative where obstetricians, family medicine physicians and pharmacists collaborated together on Project RESPECT to integrate treatment of Hepatitis C into postpartum care plans to prevent its transmission in future pregnancies.

Pediatric infectious disease clinicians at BMC are working hard to increase both testing and treatment rates among exposed infants by consulting on all birthing parents with Hepatitis C infection during their hospital stay, connecting both infant and parent(s) to care. Since beginning this program, women initiating treatment at more than twice their previous rate – an impressive statistic indeed!

“To ensure equitable access to healthcare for all individuals affected by Hepatitis C screening and treatment, it is necessary to assess what disparities exist and discover ways of eliminating them,” notes BMC clinician-scientist Epstein who also serves as assistant professor in medicine and pediatrics at Boston University’s Chobanian & Avedisian School of Medicine.
Journal reference: Biondi, B. E. et al (2024). Racial and Ethnic Disparities in Hepatitis C Care for Reproductive-Aged Women With Opioid Use Disorder. Clinical Infectious Diseases doi.org/10.1093/cid/ciae426