Report: Kentucky 1st U.S. State to Require Hepatitis C Testing for Pregnant Women

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Kentucky is now the nation’s first state to require pregnant women to get tested for the hepatitis C virus, which can easily spread from mother to child and can cause liver problems, WDRB.com reports.

The new law is a respond to the rampant rise of hepatitis C virus (HCV) in Kentucky and across the country, especially among Latinos.

Health experts support the new law, effective July 2018. It costs money to do the testing—about $240 to $310 per test—but that’s little compared to the $800,000 cost of a liver transplant, Dr. Claudia Espinosa, a pediatrician at University of Louisville, told the courier-journal.com.

“If we can save one person from liver transplant and cirrhosis, it will save a lot of money, and prevent a lot of suffering,” Espinosa said.

HCV Rates Are Increasing

CDC estimates that more than 2.7 million people live with chronic hepatitis C in the United States.

Trend data reveal a national increase in HCV detection among women of childbearing age, HCV testing among infants, and the proportion of infants born to HCV-infected mothers. This suggests increased risk for mother-to-child transmission of HCV.

This risk might be higher in certain parts of the country.

For example, Kentucky and Texas were among seven states with more than twice the national average of hepatitis C incidence in 2015, CDC reports.

Kentucky did experience a decline in rates the past few years due to statewide efforts to increase HCV knowledge among providers and drug users, and how it can be spread via needle sharing, but it remains important that providers assess women of childbearing age for HCV risk and test accordingly.

Current CDC recommendations to identify, counsel, and test persons at risk for HCV infection including pregnant women, as well as consider developing public health policies for routine HCV testing of pregnant women, and expanding current policies for testing and monitoring children born to HCV-infected women.

Expansion of HCV reporting and surveillance requirements will enhance case identification and prevention strategies.

Why Does this Matter to Latinos?

One of the main causes of the growing number of liver cancer deaths in United States is HCV.

In South Texas, the demographic most affected are Latinos, whose incidence rates are three to four times higher than that of their non-Hispanic white counterparts.

HCV infection and Hispanic ethnicity are major risk factors of HCC-related mortality in the U.S. from 1988 to 1994, according to a 2010 report. A recent CDC report also indicates that Latino men and women have the highest rates of liver cancer in the nation (20.1 and 7.7 per 100,000 men, respectively).

The greatest challenge for liver cancer control in South Texas is the high rates of HCV infection in the so-called “boomer” generation.

Among this generation, born after World War II and now ages 60-75, about 1 in 30 carry the virus. Most of those infections are not yet diagnosed.

This equates to an estimated 30-50,000 undetected HCV infections among older men and some women in South Texas. Most of these people are close to medically indigent and relying on Medicare, Medicaid and the Veteran’s Administration (VA) health system for health care.

HCV screening is estimated to save $1.5-$7.1 billion in liver disease-related costs. Because of these costs, Medicare/Medicaid and the VA guidelines for treatment require evidence of liver scarring that indicate a looming reed for a liver transplant before the costs of treatment can be reimbursed.

This makes actions like the Kentucky screening law a big priority.

“The key is diagnosing it early, and getting that patient or that baby into treatment early,” Dr. Nicholas Ryan, an OB/GYN with Norton Healthcare, told WDRB.com about the new law, passed by state lawmakers in March 2018. “Always want to take care of the mother first, and the baby as well at the same time.”