Hepatitis C secondary prevention: Difference between revisions
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{{Hepatitis C}} | {{Hepatitis C}} | ||
{{CMG}}; {{ | {{CMG}} ; '''Associate Editor(s)-In-Chief:''' {{JA}} | ||
==Overview== | |||
Patients who are diagnosed with chronic hepatitis C require vaccination against other hepatitis viruses, limiting of alcohol intake, and evaluation for other comorbid conditions in order to limit further hepatic damage. Patients should be instructed on how to avoid HCV transmission to others. | |||
==Secondary Prevention== | |||
Patients who are diagnosed with chronic hepatitis C require specific measures to limit further hepatic damage and to avoid progression to cirrhosis. | |||
===Important measures to avoid reduce the risk of further hepatic injury include:=== | |||
* Assessment of alcohol intake for all patients with HCV infection and advising limitation of alcohol | |||
* Behavioural alcohol reduction intervention in patients with moderate to high alcohol intake | |||
* Maintaining a well [[balanced diet]] that is low in fat | |||
* Evaluation for other conditions that may accelerate liver fibrosis, including HBV and HIV infections | |||
* Immunization against other hepatitis viruses([[hepatitis A]] and [[hepatitis B]]) is highly recommended<ref name="aasld2014">AASLD/IDSA/IAS–USA. Recommendations for testing, managing, and treating hepatitis C. http://www.hcvguidelines.org. Accessed July 27, 2014.</ref><br> | |||
* Studies have demonstrated an association between [[treatment]]-induced sustained [[virus|viral]] clearance and low extra-[[hepatic]] manifestations (such as, [[cryoglobulinemia|cryoglobulinemic]] [[vasculitis]], B-cell [[Non-Hodgkin lymphoma|nonHodgkin’s lymphoma]], [[acute coronary syndrome]]<ref name="pmid25398770">{{cite journal |vauthors=Hsu YC, Ho HJ, Huang YT, Wang HH, Wu MS, Lin JT, Wu CY |title=Association between antiviral treatment and extrahepatic outcomes in patients with hepatitis C virus infection |journal=Gut |volume=64 |issue=3 |pages=495–503 |date=March 2015 |pmid=25398770 |doi=10.1136/gutjnl-2014-308163 |url=}}</ref>, [[cardiovascular]] disease<ref name="pmid25716707">{{cite journal |vauthors=Innes HA, McDonald SA, Dillon JF, Allen S, Hayes PC, Goldberg D, Mills PR, Barclay ST, Wilks D, Valerio H, Fox R, Bhattacharyya D, Kennedy N, Morris J, Fraser A, Stanley AJ, Bramley P, Hutchinson SJ |title=Toward a more complete understanding of the association between a hepatitis C sustained viral response and cause-specific outcomes |journal=Hepatology |volume=62 |issue=2 |pages=355–64 |date=August 2015 |pmid=25716707 |doi=10.1002/hep.27766 |url=}}</ref>, [[insulin resistance]], and [[type 2 diabetes]]<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>) risk for [[Hepatitis C]].<ref name="CacoubLongo2021">{{cite journal|last1=Cacoub|first1=Patrice|last2=Longo|first2=Dan L.|last3=Saadoun|first3=David|title=Extrahepatic Manifestations of Chronic HCV Infection|journal=New England Journal of Medicine|volume=384|issue=11|year=2021|pages=1038–1052|issn=0028-4793|doi=10.1056/NEJMra2033539}}</ref> | |||
== | ===Precautions to prevent transmission to other individuals include:<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>=== | ||
* Covering completely any cut or wound with a waterproof dressing would help in reduction of transmission of the virus | |||
* Ensuring that the injecting equipment is not shared | |||
* Avoiding blood or organ donation | |||
* Not sharing personal items such as toothbrushes or razors | |||
* Engaging in protected intercourse whenever possible | |||
*Covering completely any cut or wound with a waterproof dressing would help in reduction of transmission of the virus | |||
* | There are currently no CDC recommendations to restrict a healthcare worker who is infected with HCV. The risk of transmission from an infected healthcare worker to a patient appears to be very low.<ref name="aasld2014">AASLD/IDSA/IAS–USA. Recommendations for testing, managing, and treating hepatitis C. http://www.hcvguidelines.org. Accessed July 27, 2014.</ref> All healthcare personnel, including those who are HCV positive, should follow strict aseptic technique and standard precautions, including appropriate hand hygiene, use of protective barriers, and safe injection practices.<ref name="aasld2014">AASLD/IDSA/IAS–USA. Recommendations for testing, managing, and treating hepatitis C. http://www.hcvguidelines.org. Accessed July 27, 2014.</ref> | ||
* | |||
* | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{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 23:11, 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 secondary prevention On the Web |
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American Roentgen Ray Society Images of Hepatitis C secondary prevention |
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Risk calculators and risk factors for Hepatitis C secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-In-Chief: Javaria Anwer M.D.[2]
Overview
Patients who are diagnosed with chronic hepatitis C require vaccination against other hepatitis viruses, limiting of alcohol intake, and evaluation for other comorbid conditions in order to limit further hepatic damage. Patients should be instructed on how to avoid HCV transmission to others.
Secondary Prevention
Patients who are diagnosed with chronic hepatitis C require specific measures to limit further hepatic damage and to avoid progression to cirrhosis.
Important measures to avoid reduce the risk of further hepatic injury include:
- Assessment of alcohol intake for all patients with HCV infection and advising limitation of alcohol
- Behavioural alcohol reduction intervention in patients with moderate to high alcohol intake
- Maintaining a well balanced diet that is low in fat
- Evaluation for other conditions that may accelerate liver fibrosis, including HBV and HIV infections
- Immunization against other hepatitis viruses(hepatitis A and hepatitis B) is highly recommended[1]
- Studies have demonstrated an association between treatment-induced sustained viral clearance and low extra-hepatic manifestations (such as, cryoglobulinemic vasculitis, B-cell nonHodgkin’s lymphoma, acute coronary syndrome[2], cardiovascular disease[3], insulin resistance, and type 2 diabetes[4]) risk for Hepatitis C.[5]
Precautions to prevent transmission to other individuals include:[6]
- Covering completely any cut or wound with a waterproof dressing would help in reduction of transmission of the virus
- Ensuring that the injecting equipment is not shared
- Avoiding blood or organ donation
- Not sharing personal items such as toothbrushes or razors
- Engaging in protected intercourse whenever possible
There are currently no CDC recommendations to restrict a healthcare worker who is infected with HCV. The risk of transmission from an infected healthcare worker to a patient appears to be very low.[1] All healthcare personnel, including those who are HCV positive, should follow strict aseptic technique and standard precautions, including appropriate hand hygiene, use of protective barriers, and safe injection practices.[1]
References
- ↑ 1.0 1.1 1.2 AASLD/IDSA/IAS–USA. Recommendations for testing, managing, and treating hepatitis C. http://www.hcvguidelines.org. Accessed July 27, 2014.
- ↑ Hsu YC, Ho HJ, Huang YT, Wang HH, Wu MS, Lin JT, Wu CY (March 2015). "Association between antiviral treatment and extrahepatic outcomes in patients with hepatitis C virus infection". Gut. 64 (3): 495–503. doi:10.1136/gutjnl-2014-308163. PMID 25398770.
- ↑ Innes HA, McDonald SA, Dillon JF, Allen S, Hayes PC, Goldberg D, Mills PR, Barclay ST, Wilks D, Valerio H, Fox R, Bhattacharyya D, Kennedy N, Morris J, Fraser A, Stanley AJ, Bramley P, Hutchinson SJ (August 2015). "Toward a more complete understanding of the association between a hepatitis C sustained viral response and cause-specific outcomes". Hepatology. 62 (2): 355–64. doi:10.1002/hep.27766. PMID 25716707.
- ↑ 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.
- ↑ Cacoub, Patrice; Longo, Dan L.; Saadoun, David (2021). "Extrahepatic Manifestations of Chronic HCV Infection". New England Journal of Medicine. 384 (11): 1038–1052. doi:10.1056/NEJMra2033539. ISSN 0028-4793.
- ↑ 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.