Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-30T21:39:39.616Z Has data issue: false hasContentIssue false
  • English
  • Français

research-article

Published online by Cambridge University Press:  02 January 2015

Larry J. Strausbaugh ,
Robert W. Pinner  and
Hugo R. Rosen
Larry J. Strausbaugh
Affiliation:
Departments of Medicine, Molecular Microbiology and Immunology, the Divisions of Gastroenterology/Hepatology and Liver Transplantation, Portland Veterans’ Affairs Medical Center, Oregon Health Sciences University, Portland, Oregon
Robert W. Pinner
Affiliation:
Departments of Medicine, Molecular Microbiology and Immunology, the Divisions of Gastroenterology/Hepatology and Liver Transplantation, Portland Veterans’ Affairs Medical Center, Oregon Health Sciences University, Portland, Oregon
Hugo R. Rosen*
Affiliation:
Departments of Medicine, Molecular Microbiology and Immunology, the Divisions of Gastroenterology/Hepatology and Liver Transplantation, Portland Veterans’ Affairs Medical Center, Oregon Health Sciences University, Portland, Oregon
*
VAMC Division of Gastroenterology/Hepatology, 3710, SW US Veterans Hospital Rd, PO Box 1034, P3-GI, Portland, OR 97207
Get access Rights & Permissions [Opens in a new window]

Abstract

First identified in the late 1980s as the main causative agent of non-A, non-B hepatitis, hepatitis C virus (HCV) infection is now the most common chronic bloodborne infection in the United States. It is likely that the number of deaths attributable to HCV-related chronic liver disease will increase substantially during the next 2 decades, and the potential economic and clinical burden related to HCV is staggering. Accordingly, it is essential to identify risk factors for transmission of HCV and implement appropriate precautions to decrease the prevalence of this emerging infection. The relative importance of the two most common types of exposures associated with transmission of HCV, ie, blood transfusion and injection drug use, has evolved over time. Strict blood-donor selection and the use of reliable serological tests have led to a significant reduction in transfusion-associated risk. Injection drug use is currently the single most important risk factor for HCV infection in the United States.

Transmission of HCV poses a serious threat to healthcare workers and patients if infection control techniques or disinfection procedures are inadequate. Potential exposures include contact of the eyes, mucous membranes, broken skin, or needlestick injury. Hospitalized patients may serve as a reservoir for transmission, and the prevalence of anti-HCV seropositivity among such patients can be as high as 20%.

The infected healthcare worker is a potential source of transmission. A recent molecular phylogenetic analysis demonstrated that a cardiac surgeon likely transmitted HCV to five of his patients during open heart surgery. In summary, nosocomial transmission has been unequivocally confirmed and underscores the need for strict infection control practices.

Type
Emerging Infectious Diseases
Information
Infection Control & Hospital Epidemiology , Volume 21 , Issue 3 , March 2000 , pp. 229 - 234
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Alter, HJ. To C or not to C: these are the questions. Blood 1995;85:1681–1695.Google Scholar
2.Alter, MJ, Coleman, PJ, Alexander, WJ, Kramer, E, Miller, JK, Mandel, E, et al. Importance of heterosexual activity in the transmission of hepatitis B and non-A, non-B hepatitis. JAMA 1989;262:1201–1205.Google Scholar
3.Lam, JP, McOmish, F, Burns, SM, Yap, PL, Mok, JY, Simmonds, P. Infrequent vertical transmission of hepatitis C virus. J Infect Dis 1993;167:572–576.Google Scholar
4.Rosen, HR. Acquisition of hepatitis C by a conjunctival splash. Am J Infect Control 1997;25:242–247.Google Scholar
5.Seeff, LB, Buskell-Bales, Z, Wright, EC, Durako, SJ, Alter, HJ, Iber, FL, et al. Long-term mortality after transfusion-associated non-A, non-B hepatitis. The National Heart, Lung, and Blood Institute Study Group. N Engl J Med 1992;327:1906–1911.CrossRefGoogle ScholarPubMed
6.Bukh, J, Miller, RH, Purcell, RH. Genetic heterogeneity of hepatitis C virus: quasispecies and genotypes. Semin Liver Dis 1995;15:41–63.Google Scholar
7.Koziel, MJ, Liang, TJ. Vaccination against hepatitis C virus infection: miles to go before we sleep. Hepatology 1994;20:758–760.Google Scholar
8.Choo, QL, Kuo, G, Weiner, AJ, Overby, LR, Bradley, DW, Houghton, M. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 1989;244:359–362.Google Scholar
9.Scniff, ER, de Medina, M, Kahn, RS. New perspectives in the diagnosis of hepatitis C. Semin Liver Dis 1999;19(suppl 1):3–15.Google Scholar
10.Conry-Cantilena, C, VanRaden, M, Gibble, J, Melpolder, J, Shakil, AO, Viladomiu, L, et al. Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. N Engl J Med 1996;334:1691–1696.Google Scholar
11.Woodfield, DG, Harness, M, Rix-Trott, K. Hepatitis C virus infections in oral and injectable drug users. NZ Med J 1993;106:332–334.Google Scholar
12.Thomas, DL, Vlahov, D, Solomon, L, Cohn, S, Taylor, E, Garfein, R, et al. Correlates of hepatitis C virus infections among injection drug users. Medicine (Baltimore) 1995;74:212–220.CrossRefGoogle ScholarPubMed
13.Garfein, RS, Vlahov, D, Galai, N, Doherty, MC, Nelson, KE. Viral infections in short-term injection drug users: the prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses. Am J Public Health 1996;86:655–661.Google Scholar
14.Rosen, HR, Chou, S, Sasaki, AW, Gretch, DR. Molecular epidemiology of hepatitis C infection in US veteran liver transplant recipients: evidence for decreasing relative prevalence of genotype IB. Am J Gastroenterol 1999;94:3015–3019.CrossRefGoogle Scholar
15.Gordon, SC, Bayati, N, Silverman, AL. Clinical outcome of hepatitis C as a function of mode of transmission. Hepatology 1998;28:562–567.CrossRefGoogle ScholarPubMed
16.Alter, MJ, Hadler, SC, Judson, FN, Mares, A, Alexander, WJ, Hu, PY, et al. Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C virus infection. JAMA 1990;264:2231–2235.Google Scholar
17.Schreiber, GB, Busch, MP, Kleinman, SH, Korelitz, JJ. The risk of transfusion-transmitted viral infections. N Engl J Med 1996;334:1685–1690.Google Scholar
18.Centers for Disease Control and Prevention. Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR 1998;47(RR-19):1–39.Google Scholar
19.Mauser-Bunschoten, EP, Bresters, D, van Drimmelen, AA, Roosendaal, G, Cuypers, HT, Reesink, HW, et al. Hepatitis C infection and viremia in Dutch hemophilia patients. J Med Virol 1995;45:241–246.CrossRefGoogle ScholarPubMed
20.Yu, MY, Mason, BL, Tankersley, DL. Detection and characterization of hepatitis C virus RNA in immune globulines. Transfusion 1994;34:596–602.CrossRefGoogle Scholar
21.Power, JP, Lawlor, E, Davidson, F, Holmes, EC, Yap, PL, Simmonds, P. Molecular epidemiology of an outbreak of infection with hepatitis C virus in recipients of anti-D immunoglobulin. Lancet 1995;345:1211–1213.Google Scholar
22.Bjoro, K, Froland, SS, Yun, Z, Samdal, HH, Haaland, T. Hepatitis C infection in patients with primary hypogammaglobulinemia after treatment with contaminated immune globulin. N Engl J Med 1994;331:1607–1611.Google Scholar
23.Kenny-Walsh, E. Clinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. Irish Hepatology Research Group. N Engl J Med 1999;340:1228–1233.Google Scholar
24.Piazza, M. Immunoglobulin transmits hepatitis C. True or false? Hepatology 1999;29:299–300.Google Scholar
25.Eggen, BM, Nordbo, SA. Transmission of HCV by organ transplantation. N Engl J Med 1992;326:411.Google ScholarPubMed
26.Pereira, BJ, Milford, EL, Kirkman, RL, Quan, S, Sayre, KR, Johnson, PJ, et al. Prevalence of hepatitis C virus RNA in organ donors positive for antibody and in the recipients of their organs. N Engl J Med 1992;327:910–915.Google Scholar
27.Pereira, BJ, Milford, EL, Kirkman, RL, Levey, AS. Transmission of hepatitis C virus by organ transplantation. N Engl J Med 1991;325:454–460.Google Scholar
28.Pereira, BJ, Wright, TL, Schmid, CH, Bryan, CF, Cheung, RC, Cooper, ES, et al. Screening and confirmatory testing of cadaver organ donors for hepatitis C virus: a US National Collaborative Study. Kidney Int 1994;46:886–892.Google Scholar
29.Rosen, HR. Impact of viral hepatitis on outcome of solid organ transplantation. Graft 1999;2:208–213.Google Scholar
30.Kelen, GD, Green, GB, Purcell, RH, Chan, DW, Qaqish, BF, Sivertson, KT, et al. Hepatitis B and hepatitis C in emergency department patients. N Engl J Med 1992;326:1399–1404.Google Scholar
31.Pham, D, Walshe, D, Montgomery, B, Buskell-Bales, Z, Collier, K, Lokken, G, et al. Seroepidemiology of hepatitis C and B in an urban VA medical center. Presented at the American Association for the Study of liver Diseases; Chicago, IL; November 1994. Hepatology 1994;20:236A Abstract.Google Scholar
32.Rosen, HR, Friedman, LS, Martin, P. Hepatitis C and the renal transplant patient. Semin Dialysis 1996;9:39–47.Google Scholar
33.Fabrizi, F, Martin, P, Dixit, V, Brezina, M, Cole, MJ, Gerosa, S, et al. Acquisition of hepatitis C virus in hemodialysis patients: a prospective study by branched DNA signal amplification assay. Am J Kidney Dis 1998;31:647–654.CrossRefGoogle ScholarPubMed
34.Seme, K, Poljak, M, Zuzec-Resek, S, Debeljak, M, Dove, P, Koren, S. Molecular evidence for nosocomial spread of two different hepatitis C virus strains in one hemodialysis unit. Nephron 1997;77:273–278.Google Scholar
35.Munro, J, Briggs, JD, McCruden, EA. Detection of a cluster of hepatitis C infections in a renal transplant unit by analysis of sequence variation of the NS5a gene. J Infect Dis 1996;174:177–180.Google Scholar
36.Le Pogam, S, Chapois, D, Christen, R, Dubois, F, Barin, F, Goudeau, A. Hepatitis C in a hemodialysis unit: molecular evidence for nosocomial transmission. J Clin Microbiol 1998;36:3040–3043.Google Scholar
37.Tokars, JI, Miller, ER, Alter, MJ, Arduino, MJ. National surveillance of dialysis associated diseases in the United States, 1995. ASAIO J 1998;44:98–107.Google Scholar
38.Niu, MT, Coleman, PJ, Alter, MJ. Multicenter study of hepatitis C virus infection in chronic hemodialysis patients and hemodialysis center staff members. Am J Kidney Dis 1993;22:568–573.Google Scholar
39.Favero, MS, Alter, MJ, Bland, LA. Dialysis-associated infections and their control. In: Bennett, JL, Brachman, P, eds. Hospital Infections. 3rd ed. Boston, MA: Little, Brown & Co; 1992:375–403.Google Scholar
40.Kellerman, S, Alter, JM. Preventing hepatitis B and hepatitis C infections in end-stage renal disease patients: back to basics. Hepatology 1999;29:291–293.Google Scholar
41.Okuda, K, Hayashi, H, Kobayashi, S, Irie, Y. Mode of hepatitis C infection not associated with blood transfusion among chronic hemodialysis patients. J Hepatol 1995;23:28–31.Google Scholar
42.Herrine, SK, Weinberg, DS. Epidemiology of hepatitis C viral infection. Infect Med 1999;16:111–117.Google Scholar
43.Gladziwa, U, Schlipkoter, U, Lorbeer, B, Cholmakow, K, Roggendorf, M, Sieberth, HG, et al. Prevalence of antibodies to hepatitis C virus in patients on peritoneal dialysis—a multicenter study. Clin Nephrol 1993;40:46–52.Google Scholar
44.Heintges, T, Wands, JR. Hepatitis C virus: epidemiology and transmission. Hepatology 1997;26:521–526.Google Scholar
45.Thomas, DL, Factor, SH, Kelen, GD, Washington, AS, Taylor, E JrQuinn, TC. Viral hepatitis in health care personnel at The Johns Hopkins Hospital. The seroprevalence of and risk factors for hepatitis B virus and hepatitis C virus infection. Arch Intern Med 1993;153:1705–1712.Google Scholar
46.Cooper, BW, Krussell, A, Tilton, RC, Goodwin, R, Levitz, RE. Seroprevalence of antibodies to hepatitis C virus in high-risk hospital personnel. Infect Control Hosp Epidemiol 1992;13:82–85.Google Scholar
47.Puro, V, Petrosillo, N, Ippolito, G. Risk of hepatitis C seroconversion after occupational exposures in health care workers. Italian Study Group on Occupational Risk of HIV and Other Bloodborne infections. Am J Infect Control 1995;23:273–277.Google Scholar
48.Lanphear, BP, Linnemann, CC JrCannon, CG, DeRonde, MM, Pendy, L, Kerley, LM. Hepatitis C virus infection in healthcare workers: risk of exposure and infection. Infect Control Hosp Epidemiol 1994;15:745–750.Google Scholar
49.Alter, MJ. Occupational exposure to hepatitis C virus: a dilemma. Infect Control Hosp Epidemiol 1994;15:742–744.Google Scholar
50.Pawlotsky, JM. Hepatitis C virus infection: virus/host interactions. J Viral Hepat 1998;5(suppl 1):3–8.Google Scholar
51.Davis, MS. Occupational hazards of operating: opportunities for improvement. Infect Control Hosp Epidemiol 1996;17:691–693.Google Scholar
52.Mitsui, T, Iwano, K, Masuko, K, Yamazaki, C, Okamoto, H, Tsuda, F, et al. Hepatitis C virus infection in medical personnel after needlestick accident. Hepatology 1992;16:1109–1114.Google Scholar
53.Esteban, JI, Gomez, J, Martell, M, Cabot, B, Quer, J, Camps, J, et al. Transmission of hepatitis C virus by a cardiac surgeon. N Engl J Med 1996;334:555–560.Google Scholar
54.Diago, M, Bewltra, M, Borderia, R, Aznar, J, Garcia, V. Outbreak of hepatitis C in Valencia: an unprecedented transmission by a probably medical malpractice. Presented at the American Association for the Study of Liver Diseases; Chicago, IL; November 1998. Hepatology 1998;28:277A. AbstractGoogle Scholar
55.Bronowicki, JP, Venard, V, Botte, C, Monhoven, N, Gastin, I, Chone, L, et al. Patient-to-patient transmission of hepatitis C virus during colonoscopy. N Engl J Med 1997;337:237–240.Google Scholar
56.Infection control during gastrointestinal endoscopy: guidelines for clinical application. Gastrointest Endosc 1988;34(3 suppl):37S–40S.Google Scholar
57.Casemore, DP, Blewett, DA, Wright, SE. Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy: interim recommendations of a Working Party of the British Society of Gastroenterology. Gut 1989;30:1156–1157.Google Scholar
58.New South Wales Health Department. Investigation of possible patient-to-patient transmission of hepatitis C in a hospital. NSW Public Health Bulletin 1994;5:47–51.Google Scholar
59.Piazza, M, Sagliocca, L, Tosone, G, Guadagnino, V, Stazi, MA, Orlando, R, et al. Sexual transmission of the hepatitis C virus and efficacy of prophylaxis with intramuscular immune serum globulin. A randomized controlled trial. Arch Intern Med 1997;157:1537–1544.Google Scholar
60.Farci, P, Alter, HJ, Wong, DC, Miller, RH, Govindarajan, S, Engle, R, et al. Prevention of hepatitis C infection in chimpanzees after antibody-mediated in vitro neutralization. Proc Natl Acad Sci USA 1994;91:7792–7796.Google Scholar
61.Henderson, DK. Postexposure prophylaxis for occupational exposures to hepatitis B, hepatitis C, and human immunodeficiency virus. Surg Clin N Am 1995;75:1175–1187.Google Scholar
62.Camma, C, Almasio, P, Craxi, A. Interferon as treatment for acute hepatitis C. A meta-analysis. Dig Dis Sci 1996;41:1248–1255.Google Scholar
63.Thompson, J. AORN’s multisite clinical study of bloodborne exposures in OR personnel. AORN J 1996;63:428–430, 433.Google Scholar