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Hepatitis skyrockets in Ky women, drugs blamed......"strongly recommends all pregnant women be tested and everyone get educated about the disease"
  CDC, Severe Increase in for mother-to-child transmission of HCV - (07/26/16)
August 5, 2016
Widespread drug abuse led hepatitis C diagnoses among young women to rise nearly 10 times faster in Kentucky than nationally in recent years, while the proportion of babies born to infected moms surged to one in 63.
These alarming new statistics come from a recent study by the U.S. Centers for Disease Control and Prevention that reveals some of the ways shooting up heroin and painkillers endangers the next generation.
"Kentucky is experiencing the ravages of a hepatitis C epidemic that has been going on for years now," said Dr. John Ward, director of CDC's Division of Viral Hepatitis and a senior author on the study. "And the state is not alone in having a large epidemic of hepatitis C," an infectious, viral liver disease. "We are concerned other states have this problem, too."
Researchers analyzed commercial laboratory data from Quest Diagnostics, information from Kentucky state health officials and national birth certificate data for the years 2011-2014. They found hepatitis C detection among women of childbearing age rose 213 percent in Kentucky, from 275 to 862 per 100,000; compared with 22 percent nationally, or 139 to 169 per 100,000. During those same years, Kentucky's health department received reports of 777 pregnant women testing positive for antibodies against hepatitis C.
Meanwhile, the proportion of babies born to women with hepatitis C in Kentucky rose 124 percent, from one in 142 to one in 63, which Ward called "very troubling and disturbing and alarming." The national increase was 68 percent, from one in 536 to one in 308. "The numbers speak for themselves," said Dr. Ardis Hoven, an infectious disease consultant for the Kentucky Department for Public Health and former president of the American Medical Association. "If you look at the risk factors, you see IV drug use is the main one," although tattoos and multiple sex partners also put people at risk. "...The study shines a light on a significant issue."
Other recent research also points to a growing problem with drug-fueled diseases in the region. One CDC report showed that 220 U.S. counties are at high risk for a rapid spread of hepatitis C and HIV among drug users – and 54 of them are in Kentucky. Another study found the rate of new hepatitis C cases among people 30 and younger more than tripled from 2006-2012 in Kentucky, Tennessee, Virginia and West Virginia.
In the latest year for which statistics are available, Kentucky had the highest rate of acute hepatitis C infections in the nation - 4 per 100,000 people in 2014, compared with a national average of 0.7 per 100,000 people.
Hepatitis C is also a growing problem in Southern Indiana, where that state's worst-ever HIV outbreak has stricken 203 people. Dr. William Cooke, the lone physician in Austin, Ind., said nearly 600 people were found to have hepatitis C during the outbreak, which was mostly tied to injecting the painkiller Opana.
Realizing the threat to children, Kentucky officials last year began requiring doctors to report all hepatitis C-infected pregnant women and children up to age 5, as well as babies born to infected women. Beginning this fall, Kentucky plans to require reporting of all hepatitis C lab test results, positive or negative. Ward praised these efforts.
Although hepatitis testing isn't mandatory in the state, Hoven said she strongly recommends all pregnant women be tested and everyone get educated about the disease. She also said Kentucky needs more needle exchanges, where addicts can trade dirty needles for clean ones, and more drug treatment to help people kick their addictions.
"Clearly, we need access to more providers of care," she said. "We will continue to work on this."
Doctors agreed the stakes are high. If girls and women 15 to 44 years old contract hepatitis C, the virus can fester inside them for decades. Up to 70 percent of hepatitis C patients will go on to develop chronic liver disease, the CDC says, with up to 20 percent developing cirrhosis of the liver and up to 5 percent dying of cirrhosis or liver cancer. Plus, nearly 6 percent of babies born to women with hepatitis C contract the disease from their mothers. Some children "clear it on their own," Hoven said, but others remain infected and are at risk for severe liver disease.
"If we help people before they get pregnant," Cooke said, "we can prevent this." New, high-priced hepatitis C drugs can actually cure the disease – although they can't be used in children and Cooke said many patients have a hard time getting their insurance to pay for them. But when infected young women get such medicines before getting pregnant, doctors said they and their future babies can benefit.
CDC researchers said their findings underscore the importance of preventing hepatitis C, identifying people at risk and testing them so that they can get into treatment quickly if they're infected.
Such measures are crucial, they said, as the scourge of painkiller and heroin abuse continues to grow. Federal statistics show that every day, 3,900 Americans begin abusing prescription opioids, 580 start using heroin and 78 die from an opioid overdose.
While Kentucky may stand out in this study, Ward said, "by no means is Kentucky the only state with this problem."
Reporter Laura Ungar, who also reports for USA TODAY, can be reached at (502)582-7190 or lungar@courier-journal.com.
Hepatitis C virus detection rates among females aged 15-44 and HCV testing rates among children aged less than 2 years between 2011-14.
US females: 139
Kentucky females: 275
USA children: 310
Kentucky children: 403
US females: 136
Kentucky females: 418
USA children: 314
Kentucky children: 602
US females: 145
Kentucky females: 564
US children: 335
Kentucky children: 823
US females: 169
Kentucky females: 862
US children: 353
Kentucky children: 1011
Source: Centers for Disease Control and Prevention

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