What is already known about this topic?

Hepatitis C virus (HCV) infection affects approximately 3.5 million persons in the United States, making it the most common bloodborne infection in the nation. Recent surveillance data demonstrate increased rates of HCV infection among adolescents and adults who are predominantly white, live in nonurban areas, and have a history of injection drug use.

What is added by this report?

During 2009–2014, maternal HCV infections nearly doubled among reporting states in the United States, with substantial state-to-state variation in prevalence. In adjusted analyses of Tennessee births, residence in a rural county was associated with a more than threefold increase in the odds of maternal HCV infection. Smoking during pregnancy and concurrent hepatitis B virus infection imparted fourfold and nearly 17-fold increased odds of maternal HCV infection, respectively.

What are the implications for public health practice?

Screening for HCV infection in women of childbearing age and provision of treatment services might reduce perinatal transmission of HCV, and monitoring of HCV-exposed infants can aid in early identification of HCV infection and related liver disease.


Rural opiate addiction poses a huge problem.  Economically disenfranchised areas without much in the line of career opportunities.  With nothing better to do, drugs are an option that appears very viable.  We have only seen the tip of this iceberg!

Dr. Raymond Oenbrink
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