(935) Associations between Social Vulnerability and Hepatitis C Virus in Pregnant Individuals with Opioid Use Disorder

Friday, February 10, 2023

3:30 PM – 5:00 PM

Objective: Individual social determinants of health have been identified as risk factors for Hepatitis C Virus (HCV), but whether community-level adverse social determinants of health are also predictive remains to be identified. We examined the association between community-level social vulnerability, HCV and its severity among pregnant individuals receiving treatment for Opioid Use Disorder (OUD).

Study Design: We conducted a retrospective cohort study of pregnant individuals with OUD who participated in a multidisciplinary prenatal/addiction care program from 2013 to 2021. Addresses were geocoded using ArcGIS and then linked at the census tract to the CDC 2018 Social Vulnerability Index (SVI). The primary exposure was the SVI as a composite measure of community-level social vulnerability, and secondarily, individual scores for four thematic domains (socioeconomic status, household composition and disability, minority status and language, housing type and transportation). The primary outcome was HCV defined as detected antibodies, and among individuals with HCV, viral load (VL) defined as RNA VL >12 IU/L. Multivariable Poisson regression with robust error variance was used to evaluate the association between SVI score, HCV and its severity.

Results:  Among 968 assessed pregnant individuals with OUD, 43.1% (417/968) had HCV antibodies, of which 65.2% (272/417) had detectable VL. Individuals with HCV were more likely to use tobacco and suffer from polysubstance use and mental health disorders (all p< .05). The composite SVI, as well as its four scales did not increase the risk of HCV (Table). Among individuals with detectable VL, they were less likely to have hepatitis A/B and mental health disorders and more likely to have HIV and polysubstance use (all p< .05). SVI, including as a composite measure was not associated with detectable VL.

Conclusion: In a population of pregnant individuals with OUD, individual risk factors for adverse social determinants of health were associated with HCV and detectable VL, but community-level social vulnerability as measured by the SVI was not associated with either outcome.

Primary Author(s)

Alexandra Stiles, MD (she/her/hers)
The Ohio State University
Columbus, Ohio, United States

Presenting Author(s)

Alexandra Stiles, MD (she/her/hers)
The Ohio State University
Columbus, Ohio, United States

Coauthor(s)

Mahmoud Abdelwahab, MD
Fellow
The Ohio State University
Columbus , Ohio, United States
Isabelle Mason, BS, MD (she/her/hers)
Resident physician
The Ohio State University
Columbus, Ohio, United States
OH
Orman T. Hall, DO
The Ohio State University College of Medicine
Columbus, Ohio, United States
JW
Jiqiang Wu, MSc
The Ohio State University
Columbus, Ohio, United States
Kartik Kailas Venkatesh, MD, PhD (he/him/his)
Assistant Professor
The Ohio State University
Columbus, Ohio, United States
Kara M. Rood, MD
Ohio State University Wexner Medical Center
Delaware, Ohio, United States