Prevention of spread of hepatitis C
Prevention of spread of hepatitis C
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DOI：
10.1053/jhep.2002.36389
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发表时间：
2002-11-01
期刊：
影响因子：
13.5
通讯作者：
Alter, MJ
中科院分区：
文献类型：
--
作者：
Alter, MJ
丙型肝炎病毒 (HCV) 通过经皮或经粘膜接触传染性血液或血液衍生体液传播。根据队列研究和急性病例对照研究的结果，在美国，与感染 HCV 相关的危险因素包括输血和血液制品以及受感染捐献者的实体器官移植、注射毒品、职业接触血液（主要是被污染的针刺）、生育受感染的母亲、与受感染的伴侣发生性行为以及多个异性伴侣。 HCV 的院内传播和医源性传播主要是在疫情爆发的情况下认识到的，并且主要是由不安全的注射操作造成的。从感染 HCV 的医护人员传染给患者的情况很少见。输血和移植作为传播源实际上已被消除，大多数（68%）新感染的丙型肝炎病例与注射吸毒有关。对非法注射毒品的一级预防将消除美国HCV感染的最大危险因素。需要广泛实施的其他预防策略包括降低风险咨询和服务以及审查和改进所有类型的医疗机构中的感染控制实践。对于感染高危人群或需要暴露后管理的人群，应定期进行 HCV 感染检测。没有建议对感染 HCV 的卫生保健工作者的专业活动进行常规限制，并且不应因 HCV 感染状况而将其排除在工作、学校、娱乐、儿童保育或其他环境之外。
Hepatitis C virus (HCV) is transmitted by percutaneous or permucosal exposure to infectious blood or blood-derived body fluids. Based on the results of cohort and acute case control studies, risk factors associated with acquiring HCV infection in the United States have included transfusion of blood and blood products and transplantation of solid organs from infected donors, injecting drug use, occupational exposure to blood (primarily contaminated needle sticks), birth to an infected mother, sex with an infected partner, and multiple heterosexual partners. Nosocomial and iatrogenic transmission of HCV primarily are recognized in the context of outbreaks, and primarily have resulted from unsafe injection practices. Transmission from HCV-infected health care workers to patients is rare. Transfusions and transplants have been virtually eliminated as sources for transmission, and most (68%) newly acquired cases of hepatitis C are related to injecting drug use. The primary prevention of illegal drug injecting will eliminate the greatest risk factor for HCV infection in the United States. Other prevention strategies that need to be widely implemented include risk reduction counseling and services and review and improvement of infection control practices in all types of health care settings. Testing for HCV infection should be routinely performed for persons at high risk for infection or who require postexposure management. There are no recommendations for routine restriction of professional activities for HCV-infected health care workers, and persons should not be excluded from work, school, play, and child care or other settings on the basis of their HCV infection status.