TY - JOUR
KW - Adult
KW - Analgesics, Opioid/therapeutic use
KW - Female
KW - Hepacivirus
KW - Hepatitis C/diagnosis/epidemiology
KW - Humans
KW - Mass Screening
KW - Methadone/therapeutic use
KW - Mexico/epidemiology
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/complications/drug therapy
KW - Pregnancy
KW - Pregnancy Complications, Infectious/diagnosis/epidemiology/prevention & control
KW - Pregnant Women/ethnology/psychology
KW - Prenatal Care/statistics & numerical data
KW - Prevalence
KW - Prospective Studies
KW - Risk Factors
KW - Young Adult
KW - Hepatitis C virus
KW - Opioid agonist pharmacotherapy
KW - Opioid-use disorder
KW - Prenatal Care
AU - Kimberly Page
AU - Lawrence Leeman
AU - Steven Bishop
AU - Sandra Cano
AU - Ludmila N. Bakhireva
A1 - 
AB - Background Given the large increases in opioid use among pregnant women and associations with hepatitis C virus (HCV) infection, screening pregnant women who are on (opioid agonist) pharmacotherapy for HCV infection has potential to inform medical care for these mothers as well as their newborns. We investigated the HCV testing cascade among pregnant women on pharmacotherapy in order to describe exposure and infection rates and to identify opportunities that would improve care. Methods Secondary analyses of laboratory results were performed for HCV testing, including anti-HCV, viremia (RNA) and genotype. Information was abstracted from the medical records of women who were followed at a comprehensive prenatal care clinic for women with substance use disorders at the University of New Mexico. Results The sample included 190 pregnant women, of whom 188 were on pharmacotherapy (43.7% on buprenorphine and 55.3% on methadone); the remaining two had tested positive for heroin or prescription opioids. A total of 178 (93.7%) were tested for anti-HCV, 94 (98.9%) of whom were tested for RNA, and 41 (57.7%) were genotyped. Prevalence of exposure to HCV by anti-HCV results was 53.3%, and 37.3% were positive for HCV RNA indicating chronic infection. Conclusions The high prevalence of exposure and infection with HCV in pregnant women involved in pharmacotherapy for a substance use disorder indicate a need for ongoing surveillance and testing for HCV. Identifying HCV during pregnancy is crucial because this identification would serve to enhance medical care and potentially prevent vertical transmission. Identifying HCV would also facilitate referrals to newly available curative HCV treatments following delivery.
AD - Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences Center, MSC10 5550, 1 University of New Mexico, Albuquerque, NM, 87131, USA. Pagek@salud.unm.edu.; Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA.; Department of Pharmacy Practice and Administrative Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA.; Department of Pharmacy Practice and Administrative Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA.; Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences Center, MSC10 5550, 1 University of New Mexico, Albuquerque, NM, 87131, USA.; Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA.; Department of Pharmacy Practice and Administrative Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA.
BT - Maternal and child health journal
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 9
CY - United States
DO - 10.1007/s10995-017-2316-x
IS - 9
JF - Maternal and child health journal
LA - eng
M1 - Journal Article
N2 - Background Given the large increases in opioid use among pregnant women and associations with hepatitis C virus (HCV) infection, screening pregnant women who are on (opioid agonist) pharmacotherapy for HCV infection has potential to inform medical care for these mothers as well as their newborns. We investigated the HCV testing cascade among pregnant women on pharmacotherapy in order to describe exposure and infection rates and to identify opportunities that would improve care. Methods Secondary analyses of laboratory results were performed for HCV testing, including anti-HCV, viremia (RNA) and genotype. Information was abstracted from the medical records of women who were followed at a comprehensive prenatal care clinic for women with substance use disorders at the University of New Mexico. Results The sample included 190 pregnant women, of whom 188 were on pharmacotherapy (43.7% on buprenorphine and 55.3% on methadone); the remaining two had tested positive for heroin or prescription opioids. A total of 178 (93.7%) were tested for anti-HCV, 94 (98.9%) of whom were tested for RNA, and 41 (57.7%) were genotyped. Prevalence of exposure to HCV by anti-HCV results was 53.3%, and 37.3% were positive for HCV RNA indicating chronic infection. Conclusions The high prevalence of exposure and infection with HCV in pregnant women involved in pharmacotherapy for a substance use disorder indicate a need for ongoing surveillance and testing for HCV. Identifying HCV during pregnancy is crucial because this identification would serve to enhance medical care and potentially prevent vertical transmission. Identifying HCV would also facilitate referrals to newly available curative HCV treatments following delivery.
PP - United States
PY - 2017
SN - 1573-6628; 1092-7875
SP - 1778
EP - 1783
EP - 
T1 - Hepatitis C Cascade of Care Among Pregnant Women on Opioid Agonist Pharmacotherapy Attending a Comprehensive Prenatal Program
T2 - Maternal and child health journal
TI - Hepatitis C Cascade of Care Among Pregnant Women on Opioid Agonist Pharmacotherapy Attending a Comprehensive Prenatal Program
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 28699096
U3 - 10.1007/s10995-017-2316-x
VL - 21
VO - 1573-6628; 1092-7875
Y1 - 2017
Y2 - Sep
ER -