Of all the people who contact me about having hepatitis C, the ones who tug at my heart the most are women with the virus who are pregnant or were pregnant. I don’t believe that guilt is justified, but I’ve never met a woman who doesn’t feel heavy with shame. It’s part of being a mom to worry, and part of being human to feel guilty. Still, I wish the guilt would go away, just as much as I wish hep C would disappear from the planet.
The opioid epidemic has caused a notable increase in the incidence of hepatitis C virus (HCV) infection among women of childbearing age in the United States. In 2017, data published in the Annals of Internal Medicine showed that the number of women in this age group with past or present HCV infection doubled, from 15,550 in 2006 to 31,039 in 2014.
The prevalence of HCV infection among pregnant women doubled from 2009 to 2014. Current HCV Guidelines recommend testing all pregnant women for hepatitis C infection, ideally at the initiation of prenatal care. Pregnant women who have risk factors for hepatitis C especially need to be tested. Regardless of risk factors, women are encouraged to ask their providers if this test will be performed.
Although the risk that an HCV-positive pregnant woman will pass the virus to her baby is low (around 6 percent), any transmission risk is too high. If the mother is co-infected with HIV, the transmission risk is two to three times greater. (Mother-to fetus transmission is called vertical transmission.)
Hepmag.com has excellent information about pregnancy and HCV-positive women, and I highly recommend taking a look at it. Below is an update that I’d like to add in honor of the recent Mother’s Day.
According to current guidelines, medical providers don’t treat women for hepatitis C while they are pregnant; they wait until the pregnancy is over, and then treat the mother. Children who have hep C are treated when they are older. However, a recent pilot study showed that pregnant women may be treated safely and successfully with Harvoni. Although we don’t know if this prevents hep C vertical transmission, it does raise the possibility of more research in this area.
I don’t want to draw conclusions where there aren’t any, but this study does raise a glimmer of hope for women who may learn during pregnancy that they have hepatitis C. The notion that we may be able to offer a cure and spare women the angst of possibly passing hep C to their babies is a sweet dream. I can’t imagine a better Mother’s Day gift.