Assessing Hepatitis C Among Perinatal Women Undergoing Treatment for Opioid Use Disorder in Kentucky [03A

Abstract

INTRODUCTION: HCV infection among women of child-bearing age in Kentucky is among the highest in the nation. Many women with opioid use disorders (OUD) are unaware of their HCV status and do not receive follow-up treatment for themselves or their infant. METHODS: Our IRB-approved cohort study evaluated HCV prevalence among pregnant and early parenting women receiving outpatient medication-assisted treatment for OUD. After informed consent, anti-HCV positive patients completed a survey and interview to assess HCV knowledge, perception of risk, and barriers to antiviral treatment. RESULTS: Of 129 clients, 76 (59%) had HCV antibodies and 52 (40%) had detectable HCV RNA; most were genotypes 1 or 3. Of the 63 eligible, 45 (71%) participated; 6 (14%) women were unaware of their current HCV infection status. Most (82%) were diagnosed with HCV prior to their most recent pregnancy and 55% were diagnosed >2 years prior; 28% had no knowledge of perinatal HCV transmission risk. Most (75%) reported that HCV treatment was important, however only 3 (7%) had received direct acting antiviral treatment; all achieved sustained virologic response. Perceived barriers included severe side effects and cost; nearly all were uninformed about Medicaid eligibility. One-third did not know anyone with prior HCV treatment. CONCLUSION: HCV prevalence in this cohort was high; despite prenatal testing, not all clients were aware of their status. Women were uninformed about perinatal transmission risk, and HCV treatment efficacy, protocols, and side effects. HCV testing and counseling is important for pregnant women even if a client has been previously diagnosed with HCV.