Skip to Accessibility Tools Skip to Content Skip to Footer

Children and Youth: The Silent Victims of the Silent HCV Epidemic – Pt. 1

What follows is part 1 of a 3 part series on the risk of HCV exposure for children and youth. Keep an eye out for part 2! And while  you wait, please send feedback in any form. Thanks!

I think there is plenty of reliable and available information that children who are in foster care, or homes where injection drug use is present, are quickly becoming the silent victims of the of HCV epidemic.

Rising rates of HCV contraction have stretched many of the resources communities have available to test, track and address HCV in a robust way. For many good reasons, much of the focus and funding for HCV testing, linkage to care and treatment access is directed towards baby boomers and people who inject drugs.

The Centers for Disease Control and Prevention (CDC) estimates 75% of all people living with HCV were born between 1945 and 1965.1 This has led to what we call birth cohort testing. In addition, the CDC estimates up to 85% of people who inject drugs (PWID) will come into contact with HCV at some point in their lives.2 This is what we call risk based testing.

Approaching the HCV epidemic in this way helps us increase awareness, prevention and screening by using some simple identifiers. We chose these two groups because they are where HCV is more common (i.e. prevalence), and where HCV is being contracted at the highest rate (i.e. incidence). The fact that HCV is more commonly found among a particular birth cohort and risk identifier is important information, and is pretty concerning by itself. Yet, as we will see, these aren’t the only two groups at risk HCV exposure and contraction.

Of course, if someone belongs to neither of those two groups that doesn’t mean they aren’t at risk, or shouldn’t receive testing. Which is why the CDC,3 U.S. Preventative Services Task Force (USPSTF) and the American Association for the Study of Liver Disease (AALD)4 also recommend HCV screening for people who identify with any of the following:

  • Long term hemodialysis
  • Being born to an HCV infected mother
  • Incarceration
  • Intranasal drug use
  • Getting an unregulated tattoo
  • Other percutaneous exposure (needle stick, or having surgery prior to universal precautions)

The great news is that being born to an HCV+ mother is on the list of things to look out for. The bad news is, according to a study out of Philadelphia, 85% of infants born to HCV positive mothers are not properly screened.5 This is alarming by itself. When you add to it that right now we don’t have universal HCV screening of pregnant mothers, and realize that in order to be screened a mother has to admit to injection drug use, the cause for concern becomes more clear.

Whether “right” or “wrong” pregnant women who may be afraid to mention past or current substance use out of fear that they’ll lose their child are likely to stay quite. Substance use is a complex mental health issue that is devastating to both the person effected by it, as well as those who care about and care for them. Our main goal should always be to create the best environment possible that allows us to screen, diagnose and treat as many HCV+ people as possible.

In part 2 we’ll take a look at some information that was released over the summer that should be cause for alarm, and what is indirectly happening that gives us an idea of what may be to come. In the meantime, I always like to hear from you! So send me a note or comment below!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Hepatitis C FAQs for Health Professionals. Centers for Disease Control and Prevention. Published 2016. Accessed December 7, 2016.
  2. People who Inject Drugs and Viral Hepatitis. Centers for Disease Control and Prevention. Published 2016. Accessed December 11, 2016.
  3. Testing Recommendations for Hepatitis C Virus Infection. Centers for Disease Control and Prevention. Published 2015. Accessed December 08, 2016
  4. AASLD-IDSA. Recommendations for testing, managing, and treating hepatitis C.
  5. Kuncio DE, Newbern EC, Johnson CC, Viner KM. Failure to Test and Identify Perinatally Infected Children Born to Hepatitis C Virus–Infected Women. Clinical Infectious Diseases. 2016;62(8):980-985. doi:10.1093/cid/ciw026.