Hepatitis C - Transmission, Prevention

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Hepatitis C - Transmission, Prevention
Hepatitis C - Transmission, Prevention

Video: Hepatitis C - Transmission, Prevention

Video: Hepatitis C - Transmission, Prevention
Video: NY Cures Hep C Campaign: “Learn about Hepatitis C Transmission and Prevention” Animated Video 2024, March
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Hepatitis C: Transmission & Prevention

Hepatitis C is a reportable, infectious viral disease of the liver. It is estimated that around 71 million people worldwide are affected by the chronic form. Since the discovery of the hepatitis C virus (HCV) in 1989, there has been an enormous increase in knowledge regarding the transmission, diagnosis and prevention of hepatitis C virus infection. Decisive progress has also been made in therapy in recent years. In Austria, the number of virus carriers is assumed to be around 26,000 people.

The most common mode of transmission in Austria is the so-called intravenous (iv) drug consumption. Addictive substances (e.g. heroin) are injected into the bloodstream using syringes. Syringes are often used by several people (“needle sharing”). Hepatitis C viruses can also be transmitted from one infected person to another in this way.

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  • Spread of hepatitis C in Europe
  • Worldwide distribution of the hepatitis C genotypes
  • How is hepatitis C transmitted?
  • How can you prevent hepatitis C infection?

Spread of hepatitis C in Europe

Proportion of residents of selected countries who have already come into contact with the hepatitis C virus and have developed antibodies against it (positive antibody detection):

  • Ireland: 0.1 percent,
  • Austria: 0.3 percent,
  • Europe on average: 1.5 percent,
  • Eastern Mediterranean: 2.3 percent,
  • Italy: five percent (most of the sick live in southern Italy).

Worldwide distribution of the hepatitis C genotypes

Genotypes are “groups of viruses” that differ in their genetic material. Seven hepatitis C genotypes (designated with the numbers 1 to 7) are currently known, which differ in the structure of their envelopes (different envelope proteins). These genotypes are in turn subdivided into numerous subtypes (denoted by the letters a, b, c, etc.).

The individual genotypes differ in the following factors:

  • Geographical distribution: In Austria, genotypes 1a and 1b are most common, followed by genotype 3, while in North and Central Africa, for example, genotype 4 and in Vietnam and Thailand, genotype 6 is predominant.
  • Distribution to the different age groups in Austria: Genotype 3a is found predominantly in younger patients and in IV drug users. This genotype is currently rarely found in the 50+ age group. Genotype 1, on the other hand, accounts for the largest proportion of HCV infections in Europe and is mainly found in older patients who have become infected via blood transfusion.
  • Choice of antiviral therapy: The different genotypes respond differently to therapy with some hepatitis C drugs. Therefore, under certain circumstances (eg ineffectiveness of a previous hepatitis C therapy), the genotype can be determined before therapy in order to be able to select the appropriate drug for the genotype at hand.

How is hepatitis C transmitted?

The hepatitis C virus is transmitted through infected blood. In order for an infection to occur, the viruses have to get directly into the bloodstream. The virus can penetrate through wounds on the skin or mucous membranes. Before the discovery of the hepatitis C virus and the associated lack of detectability, blood transfusions were the main route of infection. Patients with haemophilia (“bleeders”) had a particularly high risk at that time. Since all blood products are now tested for hepatitis C viruses, this route of infection can be practically ruled out in countries with well-functioning health systems.

Note In 20 to 30 percent of hepatitis C infections, the transmission route is uncertain.

Possible routes of infection

  • "Needle sharing" (shared use of contaminated, infected hypodermic needles, syringes, filters and spoons among drug users or shared use of the "tube" - rolled up paper or banknote - to sniff cocaine through the nose).
  • Sexual transmission (very rare): If none of the following risk situations exist, medical societies do not make a general recommendation for safer sex (condom) during sexual intercourse with HCV infected people. There is an increased risk of infection with frequently changing sex partners, especially at the time of menstrual bleeding, as well as when exercising traumatic sexual practices (unprotected anal intercourse, sadomasochism).
  • Transmission between mother and child: The risk of infection in a newborn with an HCV-infected mother at birth is between five and six percent. If the mother is also infected with HIV, the risk of transmission is ten percent. Very rare / uncertain transmission routes: In principle, transmission via the placenta is also possible during pregnancy. HCV transmission may occur during breastfeeding if the nipple is sore and the mother has a high viral load.
  • People who may come into contact with other people's blood (e.g. medical staff) are at increased risk. The risk of infection with a needlestick injury is generally less than one percent.
  • Unsanitary tattoos, piercings and acupuncture.
  • Common use of nail scissors, Clips, toothbrushes, razors, -messern and similar sanitary articles, and nasal sprays.
  • Kissing, but only when there is bleeding (e.g. bleeding gums in periodontal disease).
  • Nosocomial transmission (extremely rare): Infection in health facilities (e.g. hospital, dental practice), among other things, through infected medical staff, devices or blood products.

How can you prevent hepatitis C infection?

HCV-positive drug users should by no means engage in needle sharing. Hygiene items such as razor blades, nail scissors and toothbrushes should only be used by those affected. The laundry used does not have to be disinfected. Sharing glasses, dishes, cutlery and towels is harmless.

Partners of people infected with HCV should have a laboratory test carried out for HCV. A change in sexual practices is not necessary in stable long-term partnerships. The use of condoms is recommended for people with frequently changing sexual partners. In HCV-infected women, the desire to have children is by no means excluded. The delivery can take place normally. HCV positive mothers can breastfeed their children. However, if a nipple is injured or inflamed, the affected breast should not be used. In general, it is possible for patients with hepatitis C to lead a normal social life.

In the event of possible contact with foreign blood or other infectious body fluids - e.g. for occupational reasons or during first aid measures in the event of an accident - disposable gloves should be worn to protect yourself against hepatitis C infection. To protect other people from infection, they must be changed after contact with blood before someone else is touched.

Note There is currently no vaccination against hepatitis C. The high rate of mutations (changes in the genetic makeup of the virus) makes it difficult to develop a vaccine.

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