Co-Infection Rates of Hepatitis C in Pregnant Women with Syphilis in West Virginia
Overview
Among 161 pregnant women diagnosed with syphilis in West Virginia from 2019 to 2023, 42.9% had a past or present hepatitis C virus (HCV) infection. Women with HCV co-infection reported higher rates of incarceration and drug use, lower adherence to syphilis treatment, and increased congenital syphilis outcomes compared to those without HCV.
Background
Syphilis and hepatitis C virus (HCV) infections have been rising among women of reproductive age in the United States, with both infections capable of vertical transmission leading to adverse infant outcomes. Maternal syphilis rates more than tripled nationally from 2016 to 2022, paralleled by increasing maternal HCV infections. West Virginia has experienced a notable rise in congenital syphilis cases, and although perinatal HCV exposure is not reportable, data suggest high exposure rates. Universal screening for both infections during pregnancy is recommended, but social vulnerabilities such as substance use and incarceration may hinder screening and treatment adherence.
Data Highlights
Characteristic
HCV Present (n=69)
HCV Absent (n=92)
Past-year incarceration
21.7%
5.4%
Past-year drug use
50.7%
15.2%
Adherence to syphilis treatment
56.5%
84.8%
Reported congenital syphilis outcomes
59.4%
28.3%
Key Findings
42.9% of pregnant women with syphilis had a past or present HCV infection.
Women with HCV co-infection reported significantly higher rates of incarceration (21.7% vs 5.4%) and drug use (50.7% vs 15.2%) in the past year compared to those without HCV.
Adherence to recommended syphilis treatment was lower among women with HCV (56.5%) than those without (84.8%).
Congenital syphilis outcomes were more frequently reported in infants born to women with HCV co-infection (59.4%) versus those without (28.3%).
Integrated care approaches are needed to address overlapping infections and social vulnerabilities in this population.
Clinical Implications
Clinicians should be vigilant in screening pregnant women for both syphilis and hepatitis C, especially among those with histories of substance use or incarceration. Enhanced efforts to ensure treatment adherence for syphilis in co-infected women are critical to reduce congenital syphilis outcomes. Integrated, multidisciplinary care models addressing social determinants may improve maternal and infant health outcomes.
Conclusion
The high prevalence of HCV co-infection among pregnant women with syphilis in West Virginia, coupled with associated social vulnerabilities and poorer treatment adherence, underscores the need for integrated public health strategies to mitigate adverse maternal and congenital outcomes.
References
West Virginia Department of Health Surveillance Data 2019–2023 -- Co-Infection Rates of Hepatitis C in Pregnant Women Diagnosed with Syphilis
