The impact of hepatitis c virus infection on buprenorphine dose in pregnancy

Misty L. Mcdowell, Tiffany R. Tonismae, James E. Slaven, Mary P. Abernathy, Anthony L. Shanks, Tara D. Benjamin, Sara K. Quinney

Research output: Contribution to journalArticle


Objective Buprenorphine (BUP) is commonly used for opioid maintenance therapy in pregnancy. Our goal was to determine whether liver dysfunction related to hepatitis C virus (HCV) infection impacts BUP dosing requirements in pregnancy. Study Design âThis was a retrospective cohort study of pregnant women with antenatal exposure to BUP to compare dosing between individuals positive versus negative for HCV infection. Spearman correlation tests were used to assess the relationship between BUP dose and HCV status. Results âHCV infection was present in 103 (39%) of the patients. Patients with HCV infection required lower dose increases of BUP throughout pregnancy (p = 0.02). HCV viral load was positively correlated with the liver enzymes aspartate transaminase (r = 0.30, p = 0.003) and alanine transaminase (r = 0.25, p = 0.01). There was a negative correlation between HCV viral load and BUP dose during the second trimester (r =-0.27, p = 0.01) and third trimester (r =-0.20, p = 0.04). Conclusion âWomen with HCV infection required less of an increase in BUP dose throughout pregnancy compared with women without HCV infection. Severity of HCV infection, as measured by viral load and liver enzymes, was also associated with BUP dosing.

Original languageEnglish (US)
Pages (from-to)73-78
Number of pages6
JournalAmerican Journal of Perinatology
Issue number1
StatePublished - 2020
Externally publishedYes


  • buprenorphine
  • hepatitis C virus
  • opiate use disorder
  • pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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    Mcdowell, M. L., Tonismae, T. R., Slaven, J. E., Abernathy, M. P., Shanks, A. L., Benjamin, T. D., & Quinney, S. K. (2020). The impact of hepatitis c virus infection on buprenorphine dose in pregnancy. American Journal of Perinatology, 37(1), 73-78.