Hepatitis C

What's the Problem?

Hepatitis C is a liver disease caused by hepatitis C virus (HCV). The virus can be found in the blood of an infected person. Contact with infected blood spreads the disease. There are blood tests available to diagnose hepatitis C. Most people with acute (newly acquired) HCV infection do not have symptoms. If symptoms occur, they may include tiredness, jaundice (yellowing of the eyes and skin), loss of appetite, or stomach ache. Of 100 HCV-infected people, 75-85 will develop chronic (long-lasting) infection and 70 people will eventually develop chronic liver disease. Although less than 3% of chronically infected persons die as a result of their infection, hepatitis C remains the leading indication for liver transplantation.

Who's at Risk?

HCV infection is the most common bloodborne infection in the United States, affecting nearly three million Americans, most of whom do not know they are infected. Transmission of HCV occurs when blood or body fluids from an infected person enter the body of a person who is not infected. This occurs through sharing needles or "works" when "shooting" drugs, through contaminated needlesticks or sharps exposures on the job, or from an HCV-infected mother to her baby during birth.

About 7% of people with HCV infection may have been infected through blood transfusions before there was a more precise test for HCV to screen the blood supply. The risk for HCV infection from transfusion is now less than one per million transfused units of blood.

HCV can be spread by sexual contact, although this doesn't occur very often. A person with an HCV-infected long-term steady sex partner does not need to change sexual practices. People with multiple partners should use latex condoms consistently and correctly every time to protect themselves against diseases spread by sex (e.g., hepatitis B, gonorrhea, and AIDS). They should be vaccinated against hepatitis B, and against hepatitis A, if appropriate.

Who should be tested for evidence of HCV infection?

Can It Be Prevented?

There is no vaccine against hepatitis C. A person who tests positive for HCV infection should see a doctor to assess liver damage and determine whether medical management and antiviral therapy would be helpful. It is very important for a person with liver damage to avoid alcohol, to discuss medications (e.g., over-the-counter, herbal treatments, and prescription drugs) with a physician, and to see a physician regularly.

Tips for Scripts

INFORMviewers who think they may be at risk to talk to a physician about being tested for HCV.
ENCOURAGE viewers who shoot drugs to stop using drugs and be tested for HCV infection. If an injection drug user cannot stop using drugs, he/she should be sure to: never share needles or other drug "works"; only use clean, sterile needles; get into a treatment program to stop using drugs; and get vaccinated against hepatitis A and hepatitis B.
INFORM viewers infected with HCV never to donate blood or organs. They should not share toothbrushes, razors or other objects that might have blood on them.
REMIND viewers to use a condom the right way, every time.
REASSURE viewers that risk of acquiring HCV infection from a blood transfusion is now almost nil.

Case Example

Forty-year-old Eileen has a routine physical exam that included a risk factor history. Her physician asks if she ever injected illegal drugs. Eileen says she experimented with injection drugs, but only as a young college student. The physician explains that only one episode of injection drug use puts her at risk for HCV infection and orders tests for HCV antibodies and liver enzymes. The antibody test is positive, but enzyme tests are normal. Eileen agrees to return for periodic liver enzyme tests (several times during the next 12 months). Patients with hepatitis C may have normal liver enzymes at one point and abnormal at another. Her physician does not recommend antiviral therapy at this time.

Daycare.com would like to thank the Centers for Disease Control and Prevention (CDC) and their contributors for this information in striving to make daycare and childcare a more productive and efficient service.

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