National Trends in Hepatitis C Infection by Opioid Use Disorder Status Among Pregnant Women at Delivery Hospitalization - United States, 2000-2015

Abstract

Hepatitis C virus (HCV) is transmitted primarily through parenteral exposures to infectious blood or body fluids that contain blood (e.g., via injection drug use, needle stick injuries) (1). In the last 10 years, increases in HCV infection in the general U.S. population (1) and among pregnant women (2) are attributed to a surge in injection drug use associated with the opioid crisis. Opioid use disorders among pregnant women have increased (3), and approximately 68% of pregnant women with HCV infection have opioid use disorder (4). National trends in HCV infection among pregnant women by opioid use disorder status have not been reported to date. CDC analyzed hospital discharge data from the 2000-2015 Healthcare Cost and Utilization Project (HCUP) to determine whether HCV infection trends differ by opioid use disorder status at delivery. During this period, the national rate of HCV infection among women giving birth increased >400%, from 0.8 to 4.1 per 1,000 deliveries. Among women with opioid use disorder, rates of HCV infection increased 148%, from 87.4 to 216.9 per 1,000 deliveries, and among those without opioid use disorder, rates increased 271%, although the rates in this group were much lower, increasing from 0.7 to 2.6 per 1,000 deliveries. These findings align with prior ecological data linking hepatitis C increases with the opioid crisis (2). Treatment of opioid use disorder should include screening and referral for related conditions such as HCV infection.

FIGURE

National prevalence of maternal hepatitis C virus (HCV) infection per 1,000 delivery hospitalizations, by opioid use disorder (OUD) status, 2000–2015 * Prevalence numerator consisted of HCV infection International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes (070.41, 070.44, 070.51, 070.54, 070.70, 070.71, and V02.62), and denominator consisted of delivery hospitalizations discharges with and without opioid type dependence and nondependent opioid abuse based on ICD-9-CM codes (304.00–304.03, 304.70–304.73, and 305.50–305.53). ^† Rates are for 2000 through the third quarter of 2015.