Association Between Sex and Recent Pregnancy and Hepatitis C Virus Treatment in People With Opioid Use Disorder.
| Title: | Association Between Sex and Recent Pregnancy and Hepatitis C Virus Treatment in People With Opioid Use Disorder. |
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| Authors: | Cary CB; Department of Obstetrics and Gynecology, the Division of Infectious Diseases, and the Department of Psychiatry, Washington University School of Medicine, and the Advanced Health Data (AHEAD) Institute, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri.; McCrary LM; Department of Obstetrics and Gynecology, the Division of Infectious Diseases, and the Department of Psychiatry, Washington University School of Medicine, and the Advanced Health Data (AHEAD) Institute, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri.; Marks LR; Department of Obstetrics and Gynecology, the Division of Infectious Diseases, and the Department of Psychiatry, Washington University School of Medicine, and the Advanced Health Data (AHEAD) Institute, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri.; Kelly JC; Department of Obstetrics and Gynecology, the Division of Infectious Diseases, and the Department of Psychiatry, Washington University School of Medicine, and the Advanced Health Data (AHEAD) Institute, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri.; Hartz SM; Department of Obstetrics and Gynecology, the Division of Infectious Diseases, and the Department of Psychiatry, Washington University School of Medicine, and the Advanced Health Data (AHEAD) Institute, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri.; Hayibor L; Department of Obstetrics and Gynecology, the Division of Infectious Diseases, and the Department of Psychiatry, Washington University School of Medicine, and the Advanced Health Data (AHEAD) Institute, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri.; Grucza RA; Department of Obstetrics and Gynecology, the Division of Infectious Diseases, and the Department of Psychiatry, Washington University School of Medicine, and the Advanced Health Data (AHEAD) Institute, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri.; Xu KY; Department of Obstetrics and Gynecology, the Division of Infectious Diseases, and the Department of Psychiatry, Washington University School of Medicine, and the Advanced Health Data (AHEAD) Institute, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri.; Curtis MR; Department of Obstetrics and Gynecology, the Division of Infectious Diseases, and the Department of Psychiatry, Washington University School of Medicine, and the Advanced Health Data (AHEAD) Institute, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri. |
| Source: | O&G open [O G Open] 2025 Jul 10; Vol. 2 (4), pp. e096. Date of Electronic Publication: 2025 Jul 10 (Print Publication: 2025). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 9918787579406676 Publication Model: eCollection Cited Medium: Internet ISSN: 2994-9726 (Electronic) Linking ISSN: 29949726 NLM ISO Abbreviation: O G Open Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [Philadelphia, PA] : Wolters Kluwer Health, Inc., [2024]- |
| Abstract: | Objective: To evaluate the association between sex and recent pregnancy and treatment of hepatitis C virus (HCV) infection in individuals entering opioid use disorder (OUD) treatment in the United States.; Methods: We used the Merative MarketScan Commercial and Multi-State Medicaid Databases (2015-2019) to conduct a retrospective cohort study of individuals with HCV infection entering OUD treatment. The outcome variable of interest was the prescription of direct-acting antivirals (DAAs) after the initiation of OUD treatment, and the exposure variables of interest were sex and recent pregnancy status. We used Cox regression models to perform univariate analyses to determine differences in HCV treatment rates based on sex and recent pregnancy status and ran multivariable analyses adjusted for covariates including age, year of enrollment, insurance type, race and ethnicity, psychiatric comorbidities, co-occurring substance use disorders (alcohol use disorder, cannabis use disorder, stimulant use disorder), hospitalizations for drug-related poisoning, OUD treatment type, and Charlson Comorbidity Index score.; Results: Our analysis included 19,668 people with HCV infection initiating OUD treatment (90.8% with Medicaid insurance, 89.2% non-Hispanic White), of whom 8,864 (45.1%) were men, 7,567 (38.5%) were women without recent pregnancy, and 3,237 (16.5%) were women with recent pregnancy. Overall, 7,332 individuals (37.3%) were prescribed DAAs within 1 year of OUD treatment. Men were most likely to be prescribed DAAs within 1 year of OUD treatment (40.6%), followed by women without recent pregnancy (35.7%) and women with recent pregnancy (31.8%). In adjusted analyses, men and women without recent pregnancy had higher rates of HCV treatment compared with women with recent pregnancy (adjusted hazard ratio 1.18, 95% CI, 1.13-1.24; and 1.09, 95% CI, 1.04-1.13, respectively).; Conclusion: Among people with HCV infection entering OUD treatment in the United States, female sex and recent pregnancy are independent risk factors for reduced likelihood of direct-acting antiviral prescription, of which the latter may contribute to sex-based disparities in access to DAAs.; (© 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American College of Obstetricians and Gynecologists.) |
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| Grant Information: | K08 DA061258 United States DA NIDA NIH HHS; K12 DA041449 United States DA NIDA NIH HHS; R01 HD113199 United States HD NICHD NIH HHS; R21 DA057493 United States DA NIDA NIH HHS |
| Entry Date(s): | Date Created: 20250926 Date Completed: 20250926 Latest Revision: 20260307 |
| Update Code: | 20260307 |
| PubMed Central ID: | PMC12421971 |
| DOI: | 10.1097/og9.0000000000000096 |
| PMID: | 41001177 |
| Database: | MEDLINE |
Journal Article