Who is at increased risk for HCV infection?
The following persons are at known to be at increased risk for HCV infection (HCV):
- Current or former injection drug users, including those who injected only once many years ago
- Persons who received clotting factor concentrates (which are used to prevent or control bleeding) made before 1987, when more advanced methods for manufacturing those products were developed
- Persons who received blood transfusions or solid organ transplants before July 1992, when better testing of blood donors became available
- Chronic hemodialysis (artificial kidney) patients
- Persons with known exposure to HCV, such as
– health care workers after needle sticks involving HCV positive (infected) blood
– recipients of blood or organs from a donor who tested HCV-positive
- Persons with HIV infection or AIDS
- Children born to HCV-positive mothers
What are the chances of someone developing chronic HCV infection, chronic liver disease, cirrhosis (scarring of the liver) or liver cancer, or dying as a result of Hepatitis C?
Of every 100 persons infected with HCV, approximately
- 75 to 85 persons will go on to develop chronic infection
- 60 to 70 persons will go on to develop chronic liver disease
- 5 to 20 persons will go on to develop cirrhosis over a period of 20 to 30 years
- 1 to 5 persons will die from liver cancer or cirrhosis as a result of chronic infection.
Is Hepatitis C a common cause for liver transplantation?
- Yes. In fact, chronic HCV infection is the leading reason for liver transplants in the U.S.
Is there a Hepatitis C vaccine?
There is no vaccine available now for Hepatitis C infection. However, research is underway to develop a vaccine.
How is HCV infection transmitted, or spread?
HCV is usually spread through large or repeated skin punctures that result in exposure to infectious blood, such as:
- Injection drug use (the most common way HCV is transmitted in the U.S.)
- Before 1992, receipt of donated blood, blood products, and organs. However, this is a rare form of transmission in the U.S. since blood screening began in 1992.
- Needle stick injuries in health care settings
- Birth to an HCV-infected mother
Less Common forms of transmission are:
- Sex with an HCV-infected person
- Sharing personal items contaminated with infectious blood, such as razors or toothbrushes
Is cocaine use associated with HCV transmission?
There is little information to suggest an increased risk of HCV from snorting or smoking cocaine. However, any possible risk is difficult to separate from injection drug use and sex with HCV-infected partners.
What are the signs and symptoms of acute HCV infection?
Persons with newly acquired HCV infection usually either have no symptoms, or have symptoms so mild that the affected person probably wouldn’t even visit a doctor. When symptoms occur, they can include
- Fatigue (tiredness)
- Dark urine
- Clay-colored stool
- Abdominal pain
- Loss of appetite
- Joint pain
What are the signs and symptoms of chronic HCV infection?
Most persons with chronic HCV infection don’t have symptoms. However, many of them develop chronic liver disease, which can range from mild to severe, including cirrhosis (scarring of the liver) and liver cancer. Chronic liver disease in HCV-infected persons usually progresses slowly without any signs or symptoms for many years.
Who should be tested for HCV infection?
HCV testing is recommended for anyone at increased risk for HCV infection, including:
- Persons born from 1945 through 1965
- Persons who have ever injected illegal drugs, including those who injected only once many years ago
- Persons who received clotting factor concentrates made before 1987
- Persons who received blood transfusions or solid organ transplants before July 1992
- Patients who have ever received long-term artificial kidney (hemodialysis) treatment
- Persons with known exposure to HCV, including health care workers after needle sticks involving HCV-positive blood, and persons who received blood or organs from a donor who later tested HCV-positive
- All persons with HIV infection or AIDS
- Patients with signs or symptoms of liver disease (e.g., abnormal liver enzyme tests)
- Children born to HCV-positive mothers (to avoid detecting maternal antibody, these children should not be tested before age 18 months)
How is Chronic Hepatitis C treated?
HCV-positive persons should be evaluated (by referral or consultation, if appropriate) for presence of chronic liver disease, including their having liver function tests, evaluation for severity of liver disease and possible treatment, and determination of the need for Hepatitis A and Hepatitis B vaccination.
Until recently, a main treatment for chronic hepatitis (HCV) has been interferon. Now additional drugs have been added, and are often used in combination.
What should an HCV-infected person do to protect himself or herself from further harm?
- Avoid alcohol because it can speed up the development of cirrhosis (scaring of the liver), and irreversible liver disease.
- Check with a health professional before taking any new prescription pills, or over-the counter drugs (such as non-aspirin pain relievers), since they may damage the liver.
Should pregnant women be routinely tested for HCV?
No, pregnant women should not routinely be tested for HCV because:
- Pregnant women have no greater risk of being infected with HCV than non-pregnant women and
- There is no treatment to prevent mother-to-child transmission, or spread.
What is the risk that an HCV-infected mother will spread HCV to her infant during birth?
About 4 of every 100 infants born to HCV-infected mothers become infected with the virus. Transmission occurs at the time of birth, and there is no preventive treatment.
Should a woman with HCV breastfeed?
Probably not, because if their nipples are cracked or bleeding, there’s a possibility of infection being transmitted to the child.
Should children born to HCV-infected mothers be tested to see if they were infected at birth?
Children should be tested for HCV no sooner than 18 months of age because antibodies from the mother might last until this age.
More information on Hepatitis C can be obtained from the CDC website – http://www.cdc.gov/
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