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Hepatitis C Modes Of Transmission

What Is Hepatitis C

Management & mode of transmission of Hepatitis C – Dr. Ravindra B S

Hepatitis C is a liver infection caused by the hepatitis C virus . Hepatitis C is a blood-borne virus. Today, most people become infected with HCV by sharing needles or other equipment to inject drugs. For some people, HCV infection is a short-term or acute illness but for more than half of people who become infected with HCV, it becomes a long-term, chronic infection. Chronic HCV infection is a serious disease that can result in long-term health problems, even death. The majority of infected people might not be aware of their infection because they do not have any symptoms. There is no vaccine for hepatitis C. The best way to prevent HCV infection is by avoiding behaviors that can spread the disease, especially injecting drugs.

Finding Help For Hepatitis

If youve been diagnosed with viral hepatitis, there are a variety of resources that are available to help you. Lets explore a few of them below:

  • Your doctor. Your doctor is a great first point of contact for questions and concerns. They can help you to better understand the type of hepatitis you have, as well as how it will be treated.
  • American Liver Foundation . ALF is dedicated to ending liver disease through education, research, and advocacy. Their site has educational material about viral hepatitis, as well as ways to find doctors, support groups, and clinical trials in your area.
  • Patient assistance programs. If you have hepatitis C, the cost of antiviral drugs can be high. The good news is that many drug manufacturers have patient assistance programs that can help you pay for these medications.

The chart below is an at-a-glance summary of some of the key differences between hepatitis A, B, and C.

Hepatitis A

Differences Between Acute Hepatitis And Chronic Hepatitis

The main difference between Acute and Chronic Hepatitis is the period of time the infection has been in the body. If the infection has been for less than 6 months, it is said to be an Acute Hepatitis infection In contrast, Chronic Hepatitis infection means there is persistence of infection by the Hepatitis Virus for more than 6 months. The Hepatitis Core antigen shows whether there is Chronic hepatitis or not.

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Why Getting Tested Is Important

A blood test is one of the only ways to confirm a diagnosis of hepatitis C. Additionally, hepatitis C often has no visible symptoms for many years.

Because of this, its important to be tested if you believe youve been exposed to the virus. Getting a timely diagnosis can help ensure you receive treatment before permanent liver damage occurs.

Biology And Genetics Of Perinatal Hcv Transmission

DVC Microbiology 146 Fall 11 (Gard): Lab 38 Pathogens

Other authors attributed the biology of perinatal transmission of HCV to the infection of maternal peripheral blood mononuclear cells by the virus and to the presence of the negative strand of HCV inside the PBMC, which is a sign of viral replicative activity .

It was noted that HLA antigen class II diversity between the mother and the baby induces rapid clearance of infected maternal cells through the newborn alloimmune anti-major histocompatibility complex response this was demonstrated to be protective for perinatal transmission of HCV . A biologically reasonable explanation has been provided for these apparently contradictory results involving the important role of the interaction between HLA antigen class II molecules and CD4+ T lymphocytes in the immune response and in allo-recognition .

With regard to single nucleotide polymorphisms of interleukin -28B that have been demonstrated to be important in determining spontaneous and treatment-induced clearance of HCV in children and in adults recently, neither the mothers nor the childrens IL-28B status was associated with an increased risk of perinatal transmission .

High levels of NK cells in the placenta of HCV-positive mothers were detected by some researchers . These cells had greater cytotoxicity in the HCV-positive mothers. This may be an explanation for the relatively low rates of vertical transmission, though the increased cytotoxicity of the NK cells may also lead to a higher risk of preterm delivery .

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How Do You Get Hepatitis C

The hepatitis C virus is usually spread through blood-to-blood contact.

Some ways the infection can be spread include:

  • sharing unsterilised needles particularly needles used to inject recreational drugs
  • sharing razors or toothbrushes
  • from a pregnant woman to her unborn baby
  • through unprotected sex although this is very rare

In the UK, most hepatitis C infections happen in people who inject drugs or have injected them in the past.

It’s estimated around half of those who inject drugs have been infected with the virus.

Transmission Of Hepatitis C

The transmission of hepatitis C is by parenteral route: blood transfusion, drug addiction by IV route, accidental injections in the professional setting, tattoos, body piercing, acupuncture, dialysis patients, medical or dental care carried out with reusable poorly disinfected equipment, sharing toothbrushes and razors.

La transmission par voie sexuelle est rare, particulièrement chez les partenaires monogames. La transmission périnatale est également faible

WHO : Hepatitis C is not spread through breast milk, food, water or casual contact , or sharing food or drink with an infected person .

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How Hcv Is Spread

The hepatitis C virus is transmitted primarily through blood to blood contact, meaning that a person can become infected with the virus should the blood of a person who carries the virus be introduced into another person’s bloodstream.

Therefore, as with hepatitis B, blood transfusions , tattooing and body piercing, occupational exposure, medical procedures, and intravenous drug use can all lead to possible exposure to the virus. Unlike hepatitis B, however, sexual contact and childbirth have both been shown to be an inefficient route of exposure to HCV.

The hepatitis G virus is thought to be transmitted in a similar way to HCV.

Living With Hepatitis C Infection

How Is Hepatitis Transmitted?

Many people are living with hepatitis C. If you have hepatitis C, there are several important things that you can do to help yourself and others such as:

  • Eat a healthy diet and get plenty of rest.
  • To avoid further liver damage:
  • Do not drink alcohol.
  • Do not take medicine that can cause liver damage .
  • Get vaccinated against hepatitis A & B if you are not already immune.
  • Do not to pass the infection to anyone else by taking the following precautions, such as:
  • Do not share toothbrushes or razors with others.
  • Do not to let anyone else come into contact with your blood, urine or feces.
  • Use condoms during sexual activity.
  • Limit the number of sex partners you have.
  • If you use injection drugs, do not share needles or syringes with anyone else.
  • It is best to not get tattoos or body piercings.

Although often uncomfortable, you should notify your partner of your hepatitis C prior to having sex. You also must notify all your health care professionals of your infection, so they can take precautions.

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Blood Donations Before September 1991

Since September 1991, all blood donated in the UK is checked for the hepatitis C virus.

There’s a small chance you may have been infected with hepatitis C if:

  • you received a blood transfusion or blood products before September 1991
  • you received an organ transplant before 1992

Before 1992 donated organs were not routinely screened for hepatitis C and there is a very small risk a donated organ from someone with hepatitis C could spread the infection.

There are blood tests to check for hepatitis C infection

Can You Be A Blood Or Organ Donor

People with hepatitis C cant currently donate blood. The American Red Cross eligibility guidelines prohibit people who have ever tested positive for hepatitis C from donating blood, even if the infection never caused symptoms.

According to the Department of Health and Human Services , information on organ donation, those with underlying medical conditions shouldnt rule themselves out as organ donors. This reflects new guidelines for organ donation announced by the HHS.

People with HCV are now able to be organ donors. This is because advances in testing and medical technology can help the transplant team determine which organs or tissues can be safely used for transplantation.

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Susceptibility And Resistance To Hepatitis C

All nonimmune people are susceptible to infection. The degree of immunity following infection is uncertain. If infection resolves and the virus is cleared, the person can be reinfected with the same and other genotypes. However, there is some evidence from cohort studies that the likelihood of reinfection is reduced after the first HCV infection.

Prevention Of Acute Hepatitis C

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Patients should be advised to avoid high-risk behavior .

Blood and other body fluids are considered infectious. Risk of infection after a single needlestick exposure is about 1.8%. Barrier protection is recommended, but isolation of patients is of no value in preventing acute hepatitis C.

Risk of transmission from HCV-infected medical personnel appears to be low, and there are no CDC recommendations to restrict health care workers with hepatitis C infection from working.

Posttransfusion infection is minimized by avoiding unnecessary transfusions and screening all donors for hepatitis B and C. Screening has decreased the incidence of posttransfusion hepatitis B and hepatitis C, which are now extremely rare in the US.

No product exists for immunoprophylaxis of HCV. The propensity of HCV for changing its genome hampers vaccine development.

Preexposure or postexposure prophylaxis with antiviral therapy is not recommended.

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How To Prevent Hepatitis C

There is currently no vaccine for hepatitis C. Avoiding contact with infected blood is the only way to prevent the condition.

The most common way for people to contract hepatitis C is by injecting street drugs. Because of this, the best way to prevent hepatitis C is to avoid injecting.

Treatments can help many people quit. People in the U.S. can call the National Helpline for help with finding treatments.

If a person finds it difficult to stop, they can reduce the risk of contracting hepatitis C by never sharing drug equipment, ensuring a clean, hygienic environment, and always using new equipment, including syringes, ties, alcohol swabs, cottons, and cookers.

People who may come into contact with infected blood, such as healthcare workers and caretakers, should always wash the hands thoroughly with soap and water after any contact, or suspected contact, with blood. They should also wear gloves when touching another persons blood or open wounds.

People can also reduce their risk by making sure that any tattoo artist or body piercer they visit uses fresh, sterile needles and unopened ink.

The risk of contracting hepatitis C through sexual contact is low. Using barrier protection, such as condoms, reduces the risk of most sexually transmitted infections.

People who have hepatitis C can reduce the risk of transmitting it to others by:

There are many misconceptions about how hepatitis C spreads. People cannot transmit or contract the virus through:

How Is Hepatitis C Transmitted

Because HCV is primarily spread through contact with infected blood, people who inject drugs are at increased risk for HCV infection. HCV can also be transmitted from an infected mother to child at the time of birth, from unregulated tattoos or body piercings, and from sharing personal items that may be contaminated with infected blood, even in amounts too small to see. Much less often, HCV transmission occurs through sexual contact with an HCV-infected partner, especially among people with multiple sex partners and men who have sex with men. Currently in the United States, health care related transmission of HCV is rare, but people can become infected from accidental needle sticks and from breaches in infection control practices in health care facilities.

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Encouraging Others To Get Tested For Hepatitis C

While the odds of passing on the hepatitis C virus are low, you should still tell anyone at risk that you have hepatitis C. You should tell sexual partners, spouses, and family members. Your infection may be difficult to discuss, but anyone at potential risk must know. That way, they can get tested and treated if needed. Read more on why you should get tested for hepatitis C.

Show Sources

Paul Berk, MD, professor of medicine and emeritus chief of the division of liver disease, Mount Sinai School of Medicine, New York City chairman of the board, American Liver Foundation.

Alan Franciscus, executive director, Hepatitis C Support Project and editor-in-chief of HCV Advocate, San Francisco.

Thelma King Thiel, chair and CEO, Hepatitis Foundation International.

David Thomas, MD, professor of medicine, Johns Hopkins School of Medicine, Baltimore.

Howard J. Worman, MD, associate professor of medicine and anatomy and cell biology, College of Physicians and Surgeons, Columbia University, New York City.

The American Gastroenterological Association.

Modes Of Transmission And Epidemiology

Part 1: What is hepatitis C and how is it diagnosed?

The hepatitis C virus is transmitted by blood. Transmission is the result of exposure to infected blood, injectable drug use, medical care, and the transfusion of blood or derivatives not tested for HCV . The risk of sexual transmission of HCV is extremely low among stable heterosexual couples, but high among men who have sex with men using psychoactive substances for sexual intercourse and those exposed to traumatic practices. The risk of mother-to-child transmission is very low. Venous drug use is now the main mode of HCV transmission. The prevalence of HCV among injectable drug users is on average 70%. In France, it was 58% in 2004 and 43% in 2011. Transmission during invasive medical procedures is clearly decreasing due to a strengthening of general precautions against asepsis.

In France in 2011, the prevalence of antibodies against HCV was estimated to be 0.75%, and the prevalence of HCV RNA, which indicates an active infection, 0.42% . The incidence of acute hepatitis C in France is not known because there is no mandatory reporting system. In Europe, HCV infection is responsible for approximately 10% of cases of acute hepatitis. The diagnosis of acute hepatitis C is rare, except in certain exposed populations .

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Poor Infection Control For Tattooing And Piercing

The notes that HCV may be transmitted by receiving tattoos or piercings from unregulated settings with poor infection control standards.

Commercially licensed tattooing and piercing businesses are generally thought to be safe.

More informal settings may not have adequate safeguards to help avoid the spread of infections. Receiving a tattoo or piercing in settings such as in a prison or in a home with friends carries a of HCV transmission

Is Hepatitis C Sexually Transmitted

Can hepatitis C be spread through sexual contact?

Hepatitis C is a contagious liver disease caused by the hepatitis C virus . The disease can be passed from person to person.

Researchers in found that 1 out of every 190,000 instances of heterosexual sexual contact led to HCV transmission. Participants in the study were in monogamous sexual relationships.

HCV may be more likely to spread through sexual contact if you:

  • have multiple sexual partners
  • participate in rough sex, which is more likely to result in broken skin or bleeding
  • dont use barrier protection, such as condoms or dental dams
  • dont use barrier protection properly
  • have a sexually transmitted infection or HIV

Theres no evidence that HCV can be spread through oral sex. However, it may still be possible if blood is present from either the person giving or receiving oral sex.

For example, a slight risk may exist if any of the following are present:

  • menstrual blood
  • any other breaks in the skin in the involved areas

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How Is The Health Of Your Liver Monitored

Everyone living with HIV should have regular tests to monitor the health of their liver as part of the routine check-ups carried out by their HIV clinic. These tests are especially important if you have hepatitis C.

These include liver function tests that monitor levels of liver enzymes. Ultrasounds and scans are also important monitoring tools which may be used if more information is needed.

Sometimes its necessary to have a liver biopsy. This involves the removal of a small amount of the liver, under a local anaesthetic, for further tests on the health of your liver.

Treatments For Hepatitis C

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Hepatitis C can be treated with medicines that stop the virus multiplying inside the body. These usually need to be taken for several weeks.

Until recently, most people would have taken 2 main medicines called pegylated interferon and ribavirin .

Tablet-only treatments are now available.

These new hepatitis C medicines have been found to make treatment more effective, are easier to tolerate, and have shorter treatment courses.

They include sofosbuvir and daclatasvir.

Using the latest medications, more than 90% of people with hepatitis C may be cured.

But it’s important to be aware that you will not be immune to the infection and should take steps to reduce your risk of becoming infected again.

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What Are The Risk Factors For Hepatitis C

In the United States, having been born between 1945 and 1965, and the use of illicit injection drugs are the two most common factors associated with hepatitis C. Other risk factors include

  • having received blood transfusions prior to 1990,
  • hemodialysis, and
  • having greater than 10-lifetime sex partners.

Population studies show that hepatitis C is more common among males, non-Hispanic blacks, those with low income, and those with less than a high school education.

People who have HIV/AIDS have an increased risk for hepatitis C, because both these diseases are transmitted in the same ways, through blood and body fluids. If someone has both infections, that person is said to be co-infected with HIV and HCV.

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