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Who Is at Risk for Hepatitis C?
The nearly four million Americans chronically infected with the hepatitis C virus (HCV) can transmit the infection to others through blood and other bodily fluids. The route of transmission can usually be determined in over 90% of new cases.
People at High Risk for Hepatitis C Include:
1. Recipients of blood transfusions prior to 1990. Before 1990, most new cases of hepatitis C in the U.S. developed after blood transfusions. In 1990, a screening test for HCV was developed, significantly reducing the chances of acquiring the virus through transfusions.
2. IV drug users. Risk of infection due to IV drug use still remains high. Fifty percent to 80% of new IV drug users become infected within six to 12 months of starting to use IV drugs.
3. Intranasal cocaine users. People who share instruments for "snorting" cocaine seem to be at higher risk of acquiring hepatitis C. The reason is unknown.
4. Health care workers. Doctors, nurses, and laboratory personnel have a higher prevalence of hepatitis C than the general population. Exposure to blood products from poor safety precautions or from accidental needle sticks seems to increase their risk of acquiring the disease. The exact risk of acquiring hepatitis C from an infected needle is not known.
5. Dialysis patients. Hepatitis C can be transmitted through dialysis equipment that is not properly disposed of or disinfected.
6. Spouses and close household contacts of hepatitis C infected patients. The risk of sexual transmission from infected partner to spouse is controversial. Overall, the risk appears very low. A recent study showed a transmission rate of 1% per year in frequent sexual partners.
7. People engaged in high-risk sexual activity, such as having multiple sexual partners or sex with people infected with sexually transmitted diseases, particularly HIV. The risk is, however, quite low.
8. Recipients of body piercing or tattoos. The equipment and supplies used for piercing or tattooing can be infected with HCV, but the risk of acquiring hepatitis C through this means in the U.S. is unconfirmed.
9. Children born to women with hepatitis C. Although transmission from mother to newborn child has occurred, the degree of risk is controversial. Estimates range from 0% to 18%. Co-infection with HIV increases the overall risk.
Hepatitis C Testing Is Recommended for Anyone:
1. With a history of blood transfusions before 1990
2. On kidney dialysis
3. With a history of IV drug use
4. With a history of high-risk sexual practices (multiple partners, history of sexually transmitted diseases)
5. Who is a spouse or close household contact of someone infected with HCV
6. Who shares instruments for snorting cocaine.
There is no effective vaccine against HCV. However, treatment with immunogobulin after exposure to hepatitis C, such as following a needle stick injury or sexual contact, may reduce the risk of HCV infection.
People in high-risk groups can take precautions to prevent HCV infection. Drug users should refuse to share needles, syringes, or intranasal devises. Health care workers should practice the universal precautions that reduce the risk of accidental exposure to blood products. People who have sex with multiple partners are advised to use condoms, but there is insufficient evidence to suggest the routine use of condoms for monogamous couples. Spouses and those in close contact with HCV-infected individuals should avoid sharing toothbrushes and razors. In addition, the infected partner should take care to cover wounds and dispose of blood-soaked bandages or tampons without exposing others in the household.
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