Kentucky is first state to screen pregnant women for hepatitis C

Health officials confident this is a step toward ending further spread of infection, supporting young children

Effective July 1, 2018, all Kentucky women who are pregnant will be tested for hepatitis C (hep C) during their first prenatal visit with a health provider. The screening is now a law after Kentucky lawmakers passed Senate Bill 250 in April 2018. The bill was sponsored by Sen. Julie Raque Adams.

Norton Healthcare has been screening pregnant women for hep C since May 2016. During the past two years, more than 15,000 women have been screened, and 4 percent of them have tested positive for active infection. This exceeds the rate of infection in baby boomers (3 percent), which currently is the only group the Centers for Disease Control and Prevention (CDC) recommends screening because of its high infection rate.

Hep C is an infection caused by a virus that attacks the liver and leads to inflammation. The infection can have short- and long-term effects on health. If left untreated, hep C can lead to liver failure, liver cancer and even death.

“We have seen an uptick in the number of hepatitis C cases in Kentucky,” said Nicholas A. Ryan, M.D., OB/GYN with Woman’s Care Physicians of Louisville, a Part of Norton Women’s Care. “And even though someone may consider themselves at a very low risk for hep C, you never know. Testing all women at the initial prenatal visit eliminates that concern or identifies an opportunity for treatment.”

According to the CDC, a mother can transmit hep C to her baby in three ways: during pregnancy, during delivery or up to 27 days after the baby’s birth.

Pregnant women who test positive cannot begin treatment until after they give birth. They are provided education on the disease and lifestyle habits until the baby is born.

After delivery, it can take two months for the hep C virus to be detected in the baby.

“Post-delivery, the baby is carrying mom’s antibodies for up to 18 months,” said Michelle Rose, population health manager, Norton Healthcare. “Testing the baby for hep C any sooner is not preferred because the test is painful and requires too much blood, depleting the infant’s blood volume. Cord blood testing also is not recommended because the majority of infants in the U.S. acquire the infection during the birthing process.”

Statistically, 5 percent to 15 percent of infants born to a woman with active hep C will go on to develop chronic hep C that requires treatment.

The mother usually is screened for the virus again six weeks after delivery. If she tests positive for an active infection, she can begin treatment to cure the infection. If she tests negative, additional screening may be recommended annually. Infants should be closely followed by their pediatricians so that testing can be done between 18 and 24 months and treatment can begin if needed.

Kentucky is the first state to pass the hep C testing regulation for pregnant women. Data collected from Kentucky could prompt other states to mandate the testing.

“It’s a great moment for Kentucky and for us to ensure we are taking care of our women and our children,” Rose said. “This is a positive step toward controlling hep C because we are not only treating mom, but also screening the children and treating them if they are infected as well.”

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