Prevention of spread of hepatitis C

Abstract

T o prevent the spread of hepatitis C virus (HCV), prevention and counseling measures should be appropriate to the presence and magnitude of risk. Assessing risk is based on the epidemiologic characteristics of HCV, including modes of transmission, which persons are at increased risk or have a high prevalence of infection, and the amount of disease or infection attributable to the risk. In 1998, the Centers for Disease Control and Prevention (CDC) convened a meeting of expert consultants to review the available data and develop recommendations for the prevention and control of HCV infection. These recommendations were published in October 1998. 1 This review summarizes highlights of the epidemiologic data used to support these recommendations and includes data that have become available since that publication. Risk Factors Associated With Acquiring HCV InfectionThe most reliable data on risk factors associated with acquiring infection are obtained from cohort (prospective) studies and case control (retrospective) studies of acute disease. 2 In cohort studies of HCV infection, the presence of exposure (e.g., blood transfusion) was determined in a defined population (e.g., hospitalized patients), and the population was followed to compare the incidence of infection and disease in the exposed group compared with the incidence in the nonexposed group. In case control studies of acute hepatitis C, the population sample was selected based on the presence or absence of newly acquired, symptomatic disease, and the proportions of cases with histories of various exposures (e.g., blood transfusion, injection drug use, number of sex partners) during the 6 months before onset of disease were compared with those of the controls. For these studies, cases were identified from among persons seeking medical care for acute viral hepatitis in public and private outpatient and inpatient settings and the controls were selected

The impact of illicit drug use and harmful drinking on quality of life among injection drug users at high risk for hepatitis C infection

“…Illicit drug users who inject drugs (IDUs) place themselves at elevated risk of contracting HCV infection. HCV prevalence among IDUs ranges from 45% to 95% in cities around the world (Dore et al, 2003;Alter, 2002;Miller et al, 2002;Hahn et al, 2001;Hagan, 1998). Heavy alcohol use is also common among IDUs.…”

High prevalence of alcohol use among hepatitis C virus antibody positive injection drug users in three US cities

“…Because the annual incidence rate of HCV infection is 10-20% among many urban populations of IDUs (Garfein et al, 1998;Hagan et al, 1999) and 68% of newly acquired HCV infections in the United States are associated with injection drug use (Alter, 2002), addressing alcohol use among this population is important for slowing disease progression, increasing the effectiveness of HCV treatment and potentially reducing the risk of transmitting HCV to other injectors. Further, because young IDUs are more likely to practice high-risk injection (Becker Buxton et al, 2004) and drinking behaviors (SAMHSA, 2001), the adoption of harm reduction strategies by young IDUs may be particularly important in decreasing HCV transmission and HIV infection and reducing the risk of liver damage.…”

Hepatitis C virus infection in hemodialysis patients in Maracaibo, Venezuela

“…Risk factors for HCV infection include blood transfusion and blood products from non-tested blood donors; organ transplantation from infected donors, administration of drugs with contaminated syringes, hemodialysis, occupational exposure to blood, perinatal infection and sexual transmission 2,4,13,14,18 . Moreover, due to the great variety of human activities with potential exposure to blood, several possible biologic transmission models exist, such as from tattoos, piercings, barber shops, scarification rituals, circumcisions and acupuncture 7 .…”