{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T10:18:11Z","timestamp":1793787491412,"version":"4.6.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"crossref","award":["K12DA041449"],"award-info":[{"award-number":["K12DA041449"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"crossref","award":["K08DA061258"],"award-info":[{"award-number":["K08DA061258"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"crossref","award":["P50 MH122351"],"award-info":[{"award-number":["P50 MH122351"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"crossref","award":["R21 DA057493"],"award-info":[{"award-number":["R21 DA057493"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute of Child Health and Human Development","award":["R01 HD113199"],"award-info":[{"award-number":["R01 HD113199"]}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"crossref","award":["R61 DA062321"],"award-info":[{"award-number":["R61 DA062321"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We used the Merative MarketScan Commercial and Multi-State Medicaid Databases (2015\u20132019) 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>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\u20131.24; and 1.09, 95% CI, 1.04\u20131.13, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/og9.0000000000000096","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T21:00:34Z","timestamp":1752181234000},"page":"e096","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Association Between Sex and Recent Pregnancy and Hepatitis C Virus Treatment in People With Opioid Use Disorder"],"prefix":"10.1097","volume":"2","author":[{"given":"Caroline B.","family":"Cary","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Madeline","family":"McCrary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura R.","family":"Marks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannie C.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Hartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Hayibor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Grucza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin Y.","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan R.","family":"Curtis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8]]},"reference":[{"key":"R1-20250710","doi-asserted-by":"crossref","first-page":"e2324770","DOI":"10.1001\/jamanetworkopen.2023.24770","article-title":"Trends in the prevalence of hepatitis C infection during pregnancy and maternal-infant outcomes in the US, 1998 to 2018","volume":"6","author":"Chen","year":"2023","journal-title":"JAMA Netw Open"},{"key":"R2-20250710","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1097\/AOG.0000000000005306","article-title":"Risk factors for perinatal transmission of hepatitis C virus","volume":"142","author":"Prasad","year":"2023","journal-title":"Obstet Gynecol"},{"key":"R3-20250710","doi-asserted-by":"crossref","first-page":"38.e1","DOI":"10.1016\/j.ajog.2008.03.052","article-title":"Pregnancy complications associated with hepatitis C: data from a 2003-2005 Washington state birth cohort","volume":"199","author":"Pergam","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"R4-20250710","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.clinre.2016.07.004","article-title":"Hepatitis C infection and intrahepatic cholestasis of pregnancy: a systematic review and meta-analysis","volume":"41","author":"Wijarnpreecha","year":"2017","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"R5-20250710","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/AOG.0000000000005703","article-title":"Pregnancy outcomes in patients with hepatitis C virus infection","volume":"144","author":"Hughes","year":"2024","journal-title":"Obstet Gynecol"},{"key":"R6-20250710","doi-asserted-by":"crossref","first-page":"637","DOI":"10.7326\/M16-2575","article-title":"Oral direct-acting agent therapy for hepatitis C virus infection: a systematic review","volume":"166","author":"Falade-Nwulia","year":"2017","journal-title":"Ann Intern Med"},{"key":"R7-20250710","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/j.amepre.2023.06.016","article-title":"Hepatitis C cascade of care in the direct-acting antivirals era: a meta-analysis","volume":"65","author":"Hernandez-Con","year":"2023","journal-title":"Am J Prev Med"},{"key":"R8-20250710","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1093\/cid\/ciae426","article-title":"Racial and ethnic disparities in hepatitis C care in reproductive-aged women with opioid use disorder","volume":"79","author":"Biondi","year":"2024","journal-title":"Clin Infect Dis"},{"key":"R9-20250710","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/jvh.12628","article-title":"Higher incidence of HCV in females compared to males who inject drugs: a systematic review and meta-analysis","volume":"24","author":"Esmaeili","year":"2017","journal-title":"J Viral Hepat"},{"key":"R10-20250710","doi-asserted-by":"crossref","first-page":"e2327326","DOI":"10.1001\/jamanetworkopen.2023.27326","article-title":"Hepatitis C treatment initiation among US Medicaid enrollees","volume":"6","author":"Kapadia","year":"2023","journal-title":"JAMA Netw Open"},{"key":"R11-20250710","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1097\/AOG.0000000000005300","article-title":"Viral hepatitis in pregnancy. 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