Archives     Advertise     Editorial Calendar     Subscribe     Contact Us    


Tennessee Infants Exposed to Hep C at Birth Often Not Tested for Virus


 
Susan Lopata, MD

Most Tennessee infants exposed to hepatitis C at birth are not later tested to see if they acquired the virus, according to a study by researchers at Monroe Carell Jr. Children's Hospital at Vanderbilt and the Vanderbilt Center for Child Health Policy.

Over the past few years, hepatitis C virus rates among pregnant women, likely a consequence of the country's opioid crisis, have grown substantially.

"The increase has largely gone unnoticed," said lead investigator Susan Lopata, MD, assistant professor of Pediatrics at Children's Hospital. "Given that the most common mode of transmission in the pediatric population is vertical transmission -- from mom to baby during pregnancy or during delivery -- the rising rates of hepatitis C among pregnant women signifies an emerging public health threat to children."

The findings, published in Pediatrics, are a result of a retrospective, cohort study that looked at infants enrolled in the Tennessee Medicaid program. Using data from birth certificates and hospital/doctor billing, investigators reviewed information from more than 4,000 subjects who were exposed to the virus during a 10-year period.

The results were disheartening.

"We wanted to see if children were being adequately tested per national guidelines and to see if there were factors associated with the differences in testing rates," said Lopata. "The guidelines call for hepatitis C-exposed infants to be tested at either 2 months old or at 18 months old. The gold standard is at 18 months."

According to study results for Tennessee:

  • Fewer than 1 in 4 exposed children were tested.
  • Fewer than 1 in 5 exposed children were adequately tested.
  • Infants born to African American mothers were tested about 10% of the time.

"Many children were being missed or not adequately tested according to the medical guidelines," Lopata said. "We believe that by the time a child reaches 18 months of age, pediatricians aren't thinking about perinatal-acquired infections. They are looking at development milestones."

The focus of the study, funded by the National Institutes on Drug Abuse, was to see if children exposed to the virus either during pregnancy or during delivery received appropriate testing and to determine if hospital- and patient-level factors affected testing.

Stephen Patrick, MD, MPH, MS, director of the Center for Child Health Policy at Vanderbilt University Medical Center and senior author of the paper, said as the opioid crisis continues to spread, affecting more women and infants, there needs to be more focus on the complications of the opioid crisis, like hepatitis C.

"There's an urgent need to develop public health approaches to ensure we are treating women for hepatitis C infections before pregnancy, identifying infected women in pregnancy and ensuring all exposed infants are appropriately monitored," said Patrick, associate professor of Pediatrics and Health Policy.

Lopata's interest in determining testing rates came after her interaction with a former patient, whose mother had opioid use disorder and hepatitis C, the most common cause of liver disease. The then-3-year-old was jaundiced, had hepatitis C and needed a liver transplant.

"Despite the fact that the baby was diagnosed with neonatal abstinence syndrome (NAS), an opioid withdrawal syndrome in newborns, his hepatitis C exposure wasn't identified. He fell through the cracks. Seeing him in liver failure made me want to pursue this area of research."

According to Lopata, 185 million people, or 3% of the world's population, are infected with hepatitis C. In the United States, 3.5 million people are infected with the virus, the most common blood-borne infection.

"I believe people will be shocked to discover that we are not doing a good job testing children," Lopata said. "There is no universal screening for hepatitis C in pregnancy. Perhaps someday this would be an option to better identify moms and babies exposed so that down the road we can test them when appropriate.

"Pediatricians need to be on alert about the need to follow and appropriately test these children. We have to develop better ways to track them."

 
Share:

Related Articles:


Recent Articles

Study Shows ICU Patients with Low-Risk Penicillin Allergies Can Be Tested and Treated

Read More

Cummunity Comes Together Archives

Read More

AHA, AMA & ANA SEND JOINT LETTER TO CONGRESS ON CORONAVIRUS EMERGENCY FUNDING

Read More

Scope of Practice Update

Read More

AHIP Statement on Final CMS and ONC Interoper-ability Rules

Matt Eyles, president and CEO of America's Health Insurance Plans (AHIP), issued this statement following the Centers for Medicare & Medicaid Services' (CMS) final rule on Interoperability and Patient Access, and the Office of the National Coordinator (ONC) for Health Information Technology final rule on Interoperability, Information Blocking, and the ONC Health IT Certification Program:

Read More

Alexander Statement on Final Electronic Health Records Rules

U.S. Senate health committee Chairman Lamar Alexander (R-Tenn.) released the following statement after the Trump Administration released two final electronic health record rules:

Read More

A New Era in Nephrology

New therapies are beginning to come online to change outcomes for kidney disease patients.

Read More

Solving the Rural Health Puzzle

Hospital closures, alternative payment models, workforce issues and an older, sicker population have combined to create huge challenges in delivering rural care.

Read More

The Kidney Project: Pioneering Hope

The Kidney Project is bringing new hope to patients with end stage renal disease.

Read More

Saint Thomas, Nephrology Associates Partner on Transplant

Ascension Saint Thomas and Nephrology Associates recently announced an exclusive partnership to expand kidney transplant care.

Read More

Email Print
 
 

 

 


Tags:
None
Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: