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== | {{Hepatitis C}} | ||
{{CMG}} ; '''Associate Editor(s)-In-Chief:''' {{JA}} | |||
==Overview== | |||
In the absence of available vaccine, primary prevention of HCV depends mostly on avoiding exposure to the virus. | |||
==Primary Prevention== | |||
Unlike [[hepatitis A]] and [[hepatitis B]], there are currently no readily available vaccines for hepatitis C. Primary prevention of HCV relies mostly on measures that decrease exposure to the virus. Recommendations are based on the routes of transmission, and populations at risk. Based on [[CDC]]/ AASLD/IDSA recommendations, one-time, routine, opt-out [[HCV]] testing is recommended for all individuals aged 18 years or [[old]]er. For individuals younger than 18 [[years]], [[HCV]] testing should be performed in the setting of exposures, and conditions and behaviors where increased risk of [[HCV]] is anticipated.<ref name="Kaplan2020">{{cite journal|last1=Kaplan|first1=David E.|title=Hepatitis C Virus|journal=Annals of Internal Medicine|volume=173|issue=5|year=2020|pages=ITC33–ITC48|issn=0003-4819|doi=10.7326/AITC202009010}}</ref> | |||
{{fontcolor|red|'''''Recommendations for healthcare workers'''''}}<ref name="who">World Health Organization (WHO) 2014. Guidelines for the screening, care and treatment of persons with hepatitis C infection.http://www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/. Accessed online on July 24,2014.</ref> | |||
* Proper [[hand hygiene]] and use of gloves when indicated | |||
* Safe handling and disposal of sharps and contaminated waste | |||
* Train healthcare personnel | |||
* Test donated [[blood]] | |||
* Improve access to safe blood | |||
* Health care, emergency medical, and public safety workers after sticks with [[needles]] or sharps or [[mucosa|mucosal]] exposure to [[HCV]]-infected [[blood]] should be screened. | |||
{{fontcolor|red|'''''Recommendations for IV drug users'''''}}<ref name="who">World Health Organization (WHO) 2014. Guidelines for the screening, care and treatment of persons with hepatitis C infection.http://www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/. Accessed online on July 24,2014.</ref> | |||
* IV drug users should be offered the rapid [[hepatitis B]] [[vaccine]] regimen | |||
* Implement sterile needle and syringe programmes | |||
* Offer peer interventions to IV drug users | |||
* Offer opioid substitution therapy to treat [[opioid dependence]] to decrease risky behavior | |||
{{fontcolor|red|'''''Recommendations for sexual transmission of HCV'''''}}<ref name="who">World Health Organization (WHO) 2014. Guidelines for the screening, care and treatment of persons with hepatitis C infection.http://www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/. Accessed online on July 24,2014.</ref> | |||
* Promote correct and consistent condom use | |||
* Routine [[screening]] of sex workers in high-prevalence settings | |||
* Eliminate discrimination and gender violence. | |||
*Annual [[HCV]] testing for PWID and [[HIV]]-seropositive [[men]] who have unprotected sexual intercourse with men. Periodic testing should be offered to other individuals with ongoing [[risk factors]] for exposure to [[HCV]].<ref name="Kaplan2020">{{cite journal|last1=Kaplan|first1=David E.|title=Hepatitis C Virus|journal=Annals of Internal Medicine|volume=173|issue=5|year=2020|pages=ITC33–ITC48|issn=0003-4819|doi=10.7326/AITC202009010}}</ref> | |||
{{fontcolor|red|'''''Recommendations for pregnant females and children born to the infected'''''}}<ref name="Kaplan2020">{{cite journal|last1=Kaplan|first1=David E.|title=Hepatitis C Virus|journal=Annals of Internal Medicine|volume=173|issue=5|year=2020|pages=ITC33–ITC48|issn=0003-4819|doi=10.7326/AITC202009010}}</ref> | |||
One-time screening of [[pregnant]] females is recommended unless [[risk factors]] require additional testing. | |||
* Children born to [[HCV]]-infected [[females]]. | |||
{{fontcolor|red|'''''Recommended screening for individuals with risk exposures'''''}}<ref name="Kaplan2020">{{cite journal|last1=Kaplan|first1=David E.|title=Hepatitis C Virus|journal=Annals of Internal Medicine|volume=173|issue=5|year=2020|pages=ITC33–ITC48|issn=0003-4819|doi=10.7326/AITC202009010}}</ref> | |||
*Individuals who have ever received long-term [[hemodialysis]], had [[percutaneous]]/[[parenteral]] exposure in unregulated setting. | |||
* Screening for recipients of transfusions or organ [[transplant]]s, including individuals who got notified having received [[blood]] from a later [[diagnosed]] [[HCV]] positive donor. Individuals who received a [[blood]] [[transfusion]] transfusion or an organ transplant before July 1992, received [[clotting factor]] concentrates produced before 1987, ever incarcerated. | |||
*Individuals with [[HIV]] infection, plan on initiating preexposure [[prophylaxis]] for [[HIV]], with unexplained [[chronic liver disease|CLD]], [[chronic hepatitis]], and solid organ donors ([[alive]] or [[dead]]) | |||
==Vaccinations<ref name="pmid29703790">{{cite journal |vauthors=Cacoub P, Desbois AC, Comarmond C, Saadoun D |title=Impact of sustained virological response on the extrahepatic manifestations of chronic hepatitis C: a meta-analysis |journal=Gut |volume=67 |issue=11 |pages=2025–2034 |date=November 2018 |pmid=29703790 |doi=10.1136/gutjnl-2018-316234 |url=}}</ref>== | |||
*For individuals with [[chronic liver disease|CLD]] and [[chronic]] [[hepatitis C]], [[vaccination]] against [[hepatitis A]], is recommended. | |||
*Individuals with [[cirrhosis]] should receive [[vaccination]] against [[pneumococcus]], and annual ones against [[influenza]]. | |||
*For individuals co-infected with [[HIV]] and [[HCV]], suppressive antiretroviral therapy has been shown to be associated with slower progression of [[fibrosis]]. | |||
==References== | ==References== | ||
{{Reflist| | {{Reflist|1}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:FinalQCRequired]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category: | [[Category:Hepatology]] | ||
Latest revision as of 23:12, 12 June 2021
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Hepatitis C |
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Diagnosis |
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Treatment |
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Hepatitis C primary prevention On the Web |
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American Roentgen Ray Society Images of Hepatitis C primary prevention |
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Risk calculators and risk factors for Hepatitis C primary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-In-Chief: Javaria Anwer M.D.[2]
Overview
In the absence of available vaccine, primary prevention of HCV depends mostly on avoiding exposure to the virus.
Primary Prevention
Unlike hepatitis A and hepatitis B, there are currently no readily available vaccines for hepatitis C. Primary prevention of HCV relies mostly on measures that decrease exposure to the virus. Recommendations are based on the routes of transmission, and populations at risk. Based on CDC/ AASLD/IDSA recommendations, one-time, routine, opt-out HCV testing is recommended for all individuals aged 18 years or older. For individuals younger than 18 years, HCV testing should be performed in the setting of exposures, and conditions and behaviors where increased risk of HCV is anticipated.[1]
Recommendations for healthcare workers[2]
- Proper hand hygiene and use of gloves when indicated
- Safe handling and disposal of sharps and contaminated waste
- Train healthcare personnel
- Test donated blood
- Improve access to safe blood
- Health care, emergency medical, and public safety workers after sticks with needles or sharps or mucosal exposure to HCV-infected blood should be screened.
Recommendations for IV drug users[2]
- IV drug users should be offered the rapid hepatitis B vaccine regimen
- Implement sterile needle and syringe programmes
- Offer peer interventions to IV drug users
- Offer opioid substitution therapy to treat opioid dependence to decrease risky behavior
Recommendations for sexual transmission of HCV[2]
- Promote correct and consistent condom use
- Routine screening of sex workers in high-prevalence settings
- Eliminate discrimination and gender violence.
- Annual HCV testing for PWID and HIV-seropositive men who have unprotected sexual intercourse with men. Periodic testing should be offered to other individuals with ongoing risk factors for exposure to HCV.[1]
Recommendations for pregnant females and children born to the infected[1] One-time screening of pregnant females is recommended unless risk factors require additional testing.
Recommended screening for individuals with risk exposures[1]
- Individuals who have ever received long-term hemodialysis, had percutaneous/parenteral exposure in unregulated setting.
- Screening for recipients of transfusions or organ transplants, including individuals who got notified having received blood from a later diagnosed HCV positive donor. Individuals who received a blood transfusion transfusion or an organ transplant before July 1992, received clotting factor concentrates produced before 1987, ever incarcerated.
- Individuals with HIV infection, plan on initiating preexposure prophylaxis for HIV, with unexplained CLD, chronic hepatitis, and solid organ donors (alive or dead)
Vaccinations[3]
- For individuals with CLD and chronic hepatitis C, vaccination against hepatitis A, is recommended.
- Individuals with cirrhosis should receive vaccination against pneumococcus, and annual ones against influenza.
- For individuals co-infected with HIV and HCV, suppressive antiretroviral therapy has been shown to be associated with slower progression of fibrosis.
References
- ↑ 1.0 1.1 1.2 1.3 Kaplan, David E. (2020). "Hepatitis C Virus". Annals of Internal Medicine. 173 (5): ITC33–ITC48. doi:10.7326/AITC202009010. ISSN 0003-4819.
- ↑ 2.0 2.1 2.2 World Health Organization (WHO) 2014. Guidelines for the screening, care and treatment of persons with hepatitis C infection.http://www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/. Accessed online on July 24,2014.
- ↑ Cacoub P, Desbois AC, Comarmond C, Saadoun D (November 2018). "Impact of sustained virological response on the extrahepatic manifestations of chronic hepatitis C: a meta-analysis". Gut. 67 (11): 2025–2034. doi:10.1136/gutjnl-2018-316234. PMID 29703790.