Sharing of Snorting Straws and Hepatitis C Virus Infection in Pregnant Women

Fernandez, Noelle; Towers, Craig V.; Wolfe, L. S.; Hennessy, Mark; Weitz, Beth; Porter, Stephanie S.

doi:10.1097/aog.0000000000001507

Cited by 27 publications

(17 citation statements)

References 14 publications

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“…Increasing rates of HCV infection among reproductive-aged women has led to a rise in the prevalence of HCV in pregnancy. Approximately 60-75% of pregnant women with a history of opioid abuse are HCV positive, with 63-72% reporting a history of injection drug use (Fernandez, Towers et al 2016, Krans, Zickmund et al 2016). Vertical transmission occurs in approximately 5-6% of HCV RNA positive pregnancies and is the most common route of new infections in young children (Benova, Mohamoud et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Hepatitis C Virus Knowledge Among Pregnant Women with Opioid Use Disorder

Rothenberger

Morrison

Park

et al. 2018

Matern Child Health J

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Objectives To evaluate Hepatitis C virus (HCV) knowledge and awareness among pregnant women with opioid use disorder (OUD). Methods From May through November 2015, a one-time survey was distributed to a convenience sample of pregnant women with OUD to assess their knowledge and awareness of (a) risk factors for HCV infection, (b) HCV transmission prevention strategies, (c) hepatotoxic risk reduction and (d) perinatal transmission and neonatal implications of HCV infection. Chi square and Fisher's exact tests were used to compare demographic characteristics and HCV knowledge between participants who were HCV positive and negative. Results Of 179 pregnant women with OUD approached, 169 (94%) completed the survey. Of these, 153 (90.5%) reported at least one risk factor for HCV infection, 85 (50.3%) were HCV positive and 38 (44.7%) of HCV positive women were diagnosed with HCV for the first time during pregnancy. When HCV knowledge was evaluated, 114 (66.7%) responded that sharing eating utensils could transmit HCV, 69 (55.0%) responded that there is a vaccine to prevent HCV and 56 (32.7%) did not identify intranasal drug use as a risk factor for HCV transmission. Among HCV positive women, 61 (71.8%) associated breastfeeding with an increased risk for HCV transmission, 33 (38.1%) failed to identify the importance of pediatric follow-up for HCV-exposed children and 16 (18.8%) perceived the risk of HCV vertical transmission as "likely" or "very likely." Conclusions for Practice Gaps in HCV knowledge exist among a rapidly growing population of pregnant women with OUD. Healthcare providers have a unique opportunity to provide HCV education and counseling during pregnancy.

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Section: Introductionmentioning

confidence: 99%

Hepatitis C Virus Knowledge Among Pregnant Women with Opioid Use Disorder

Rothenberger

Morrison

Park

et al. 2018

Matern Child Health J

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“…In this issue, Fernandez, et al 1 (see page XXX) challenge us to acknowledge that the current risk factor-based approach to hepatitis C virus (HCV) screening in pregnancy may require closer scrutiny. Their study was conducted in Appalachia, where, as in so many parts of our country, opiate abuse is reaching an epidemic proportion.…”

mentioning

confidence: 99%

“…Data presented by Fernandez and colleagues suggest that these exposures could be more salient in pregnancy than the current guidelines suggest. 1 …”

mentioning

confidence: 99%

Hepatitis C Virus Screening in Pregnancy

Prasad

2016

Obstetrics &Amp; Gynecology

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“…The high percentage of intranasal drug use also supports previous findings from a study conducted in Knoxville, Tennessee, that assessed HCV transmission risk factors among pregnant women and determined that sharing snorting utensils when inhaling drugs intranasally could be an additional risk factor for HCV transmission and was more common among this population than intravenous drug use. 15…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Status, Risk Factors, and Opportunities for Referral to Care Among Reproductive-Aged Women With Newly Reported Chronic Hepatitis C Virus Infection in Tennessee

et al. 2019

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Objectives: From 2006 through 2012, the number of acute hepatitis C virus (HCV) infections increased 364% among persons aged ≤30, including reproductive-aged women, in Central Appalachian states. Outreach to reproductive-aged women with newly diagnosed HCV infection affords a unique opportunity to provide counseling, further testing, and linkage to treatment. We modeled a centrally located statewide effort to reach this population and their health care providers to ascertain pregnancy status, HCV risk factors, and opportunities for linkage to additional services. Methods: Using the Tennessee Department of Health’s surveillance database, we identified women aged 18-45 residing in Tennessee with newly reported chronic HCV infection from May through October 2017. We contacted health care providers and patients to request information on pregnancy status and HCV risk factors as well as to provide linkage to treatment services. Results: Of 1548 women included in this study, health care provider or patient contact information was available for 1316 (85.0%) women. Of the 1316 women, 806 (61.2%) women had a health care provider or patient response, of whom 242 (30.0%) were pregnant. Of 296 patients contacted, 194 (65.5%) reported intranasal drug use, 193 (65.2%) reported having been incarcerated for more than 24 hours, and 180 (60.8%) reported injection drug use. Ninety-eight (33.1%) patients were referred for confirmatory testing, and 174 (58.8%) were referred to treatment. Conclusion: A high proportion of reproductive-aged women with newly diagnosed HCV infection were pregnant. Surveillance-informed outreach to this population was feasible and provided opportunities for counseling and linkage to confirmatory testing and treatment. Future studies should evaluate whether a similar model would enhance testing and linkage to care of HCV-exposed infants.

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Sharing of Snorting Straws and Hepatitis C Virus Infection in Pregnant Women

Abstract: Sharing snorting utensils (straws) in noninjection drug use may be an additional risk factor for HCV and other virus transmission.

Cited by 27 publications

References 14 publications

Hepatitis C Virus Knowledge Among Pregnant Women with Opioid Use Disorder

Hepatitis C Virus Knowledge Among Pregnant Women with Opioid Use Disorder

Hepatitis C Virus Screening in Pregnancy

Pregnancy Status, Risk Factors, and Opportunities for Referral to Care Among Reproductive-Aged Women With Newly Reported Chronic Hepatitis C Virus Infection in Tennessee

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