As the opioid epidemic continues to ravage the United States, an alarming rise in hepatitis C cases has emerged, particularly affecting vulnerable groups such as children and new mothers. Hepatitis C, a bloodborne virus that primarily spreads through shared needles and can be transmitted from mother to child during pregnancy or childbirth, poses severe health risks if untreated. Despite the availability of effective direct-acting antiviral therapies, recent studies highlight significant treatment gaps for these populations.
Two studies from Washington University School of Medicine in St. Louis shed light on these disparities. One, published in Pediatrics, reveals that children with hepatitis C are often not referred for care, with treatment access varying by race, location, and age. Another study, featured in Obstetrics & Gynecology Open, indicates that recently pregnant women with hepatitis C are less likely to receive treatment compared to other adults.
Disparities in Hepatitis C Treatment for Children
Dr. Megan Curtis, an assistant professor in the Division of Infectious Diseases at WashU Medicine, has been at the forefront of research into treatment access disparities. Analyzing data from a national database, Curtis identified 928 pediatric patients who tested positive for hepatitis C between 2000 and 2022. Her findings are concerning: only about one in eight children received treatment, with significant disparities based on demographics.
Children born between 2014 and 2018 were more likely to receive treatment, reflecting changes in Medicaid and insurance coverage and increased availability of pediatric treatments. However, their treatment rates remain lower than those for adults. Racial and geographic disparities were also evident, with Hispanic and White children more likely to receive care than Black children, and those in the South less likely to be treated than those in other regions.
“Parents might also delay because of the difficulty of administering a medicine to a young child,” Curtis noted, “and clinicians may delay treatment because some children who have hepatitis C will spontaneously clear it on their own. However, this isn’t always the case.”
Treatment for Recently Pregnant Women Lags
The rise in hepatitis C infections among individuals with opioid use disorders has highlighted treatment disparities between sexes. Curtis, alongside Kevin Xu, MD, and their team, explored whether pregnancy contributes to these disparities. Their study, using an administrative claims database, found that recently pregnant women with hepatitis C were almost 30% less likely to receive treatment compared to men and 11% less likely than non-pregnant women.
“People with hepatitis C are often asymptomatic for years after being exposed, so if you are young, otherwise healthy, and have a new baby, getting prompt treatment may not be a top priority,” said Caroline Cary, a third-year medical student and study co-author. “It’s imperative to make hepatitis C care more readily accessible to new moms considering the long-term consequences of the condition.”
Addressing the Treatment Gap
For Dr. Curtis, the gap in treatment access is a pressing issue. Despite the availability of highly effective treatments, barriers to access persist, undermining efforts to eliminate hepatitis C. Curtis emphasizes the need for comprehensive strategies to increase treatment availability and awareness, particularly for those most at risk.
“We need to come up with better strategies for addressing hepatitis C,” Curtis stated. “We have all the tools to eliminate it. We have medications that can treat it. We know the people who need to get it. We just need to step up the availability and the awareness. We could be done with hepatitis C in a generation.”
The findings from these studies underscore the critical need for targeted interventions to ensure equitable access to hepatitis C treatment. As the opioid crisis continues to fuel the spread of the virus, addressing these disparities is essential for public health. Moving forward, policymakers and healthcare providers must prioritize efforts to close the treatment gap, ensuring that all individuals, regardless of age or pregnancy status, receive the care they need.
