A recent investigation in Kentucky has found that hepatitis C virus (HCV) cases have skyrocketed among children across the state, a brutal side effect of the ongoing opioid epidemic, The Courier Journal reports.

What’s more, local advocates say attempts to prevent, track and control the liver virus have fallen short for pediatric patients — meaning many kids aren’t getting the care they need.

According to state records, one in 56 births from 2014 to 2016 in the state were to moms with a history of hepatitis C infection. According to the data, these types of births have more than quadrupled, increasing from 260 in 2010 to 1,057 in 2016.

Doctors say it’s difficult to track how many Kentucky kids have gone on to develop chronic hep C, as state records show most don’t get the necessary testing when they’re toddlers. Currently, it is estimated that as many as 46,000 U.S. children are living with the virus. Research suggests that Kentucky’s pediatric crisis is worse than other states due to the breadth of substance use disorders among young women across the state. 

One federal study showed that hepatitis C has risen more than 200 percent among Kentucky women of childbearing age over the past four years. The current HCV rate in this group is 872 cases per 100,000 women, nearly 10 times the national rise of 22 percent. 

In order to stop the crisis, the report suggests significantly increased tracking of children born to HCV-positive mothers as well as regular testing for those considered to be at risk for infection. Ramping up prevention services, such as syringe exchanges and grassroots outreach, would also help combat the crisis.

If left untreated, children with hepatitis C can develop serious liver problems as adults. Though the virus generally takes a slow toll, it can advance quickly in some children. For instance, local doctors have reported patients as young as 15 requiring a liver transplant s a result of complications from the virus.

Fortunately, the hepatitis C cure Harvoni (ledipasvir/sofosbuvir) was approved last year for children 12 years and older. To learn more about hepatitis C in children, click here.