Hepatitis C secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

Secondary Prevention

People who have hepatitis C should consider making following changes to their lives:

• Reducing alcohol intake
• Maintaining a well balanced diet i.e. low in fat and considering overall health maintenance.
• Consult a physician for regular monitoring of the condition and, if necessary, he may refer to a specialist.
• Immunization against other hepatitis viruses for which there are vaccines (i.e. hepatitis A and hepatitis B) should be considered.
• Covering completely any cut or wound with a waterproof dressing would help in reduction of transmission of the virus.
• Should ensure that the injecting equipment are not shared.
• Should not donate blood or body organs.
• Should not share personal items such as toothbrushes or razors.
• Any blood spills — including dried blood, which can still be infectious — should be cleaned using a dilution of one part household bleach to 10 parts water. Gloves should be worn when cleaning up blood spills.

There are no CDC recommendations to restrict a health care worker who is infected with HCV. The risk of transmission from an infected health care worker to a patient appears to be very low. All health care 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.

Recommendation for Counseling: AASLD Practice Guidelines 2009

“

1. Persons infected with HCV should be counseled on how to avoid HCV transmission to others, as indicated below (Class I, level C) Measures to Avoid Transmission of HCV HCV-infected persons should be counseled to avoid sharing toothbrushes and dental or shaving equipment, and be cautioned to cover any bleeding wound in order to prevent contact of their blood with others Persons should be counseled to stop using illicit drugs. Those who continue to inject drugs should be counseled to avoid reusing or sharing syringes, needles, water, cotton or other paraphernalia; to clean the injection site with a new alcohol swab; and to dispose of syringes and needles after one use in a safe, puncture-proof container HCV-infected persons should be advised to not donate blood, body organs, other tissue or semen HCV-infected persons should be counseled that the risk of sexual transmission is low, and that the infection itself is not a reason to change sexual practices ( i.e., those in long term relationships need not start using barrier precautions and others should always practice "safer" sex)

”

Recommendation for Secondary Prevention: AASLD Practice Guidelines 2009

“

1. All persons with chronic HCV infection who lack antibodies to hepatitis A and B should be offered vaccination against these two viral infections (Class IIa, Level C). 2. Persons with chronic HCV infection should be advised to abstain from alcohol consumption (Class IIb, Level C). 3. No recommendation can be made for the use of herbal products. There is no current evidence that herbal products have a role in the treatment of patients with acute or chronic HCV infection, (Class III, level C).

”