Experts in British Columbia are requesting universal screening for hepatitis C in pregnant women in Canada so that if they are infected, they can be treated with drugs after delivery and before they get pregnant again.
The Vancouver Sun reports that the hepatitis C test would be added to screening already routinely done during pregnancies for HIV and hepatitis B. Hepatitis C was recognized and named as a virus causing liver damage in the late 1980s. The opioid epidemic and injection drug use have been major factors in the rising number of infections in North America.
In the Canadian Medical Association Journal, Dr. Chelsea Elwood, an OBGYN and reproductive infectious diseases specialist and her co-authors say there are about 3,500 pregnant women with hepatitis C each year in Canada and transmission rates from infected mothers to newborns during delivery range from five to 10 per cent. As there is not enough evidence on safety in favour of treatment during pregnancy, medication between pregnancies is the safest approach.
According to a study recently presented at a Seattle medical conference, hepatitis C treatment given to women during pregnancy was effective and was afe for babies. However, experts said larger studies are necessary to confirm safety and effectiveness of treatment during pregnancy.
Screening might also give doctors a chance to suggest lifestyle changes and provide better health monitoring to avoid transmission to infants in subsequent pregnancies, the B.C. authors say. Screening that identifies positive cases would also help ensure that infants born to such mothers are tested.
There were about 2,300 new diagnoses of hepatitis C in B.C. in 2017, according to the B.C. Centre for Disease Control. Figures for 2018 were not available, but in 2012, there were about 73,000 people living with hepatitis C in B.C. At the beginning of 2018, that number had shrunk to 33,000. In 2017, the government provided drug funding for 2,657 people at a cost of $45,000 to over $100,000 per patient.
Naveed Zafar Janjua, a scientist at the Centre for Disease Control and UBC, said the number of people with hepatitis C has decreased because some people have been cured through treatment, some have died, and 25 per cent of people clear the virus without treatment. Individuals who take drugs can become reinfected if they re-engage in risky behaviours like sharing contaminated needles or having sex with infected individuals. According to Janjua, it is preferable to treat people at an earlier stage of the disease.
Also, research has indicated that more than 70 per cent of those who inject drugs have hepatitis C. In another program, doctors at the LAIR Centre in Vancouver will try to detect, treat and cure patients with hepatitis C while they are receiving therapy. The medical office will use a clinical trial model to simultaneously address addictions and hepatitis C “in one place at one time.”