Prevention of spread of hepatitis C
Prevention of spread of hepatitis C
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DOI：
10.1002/hep.1840360712
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发表时间：
2002-11
期刊：
影响因子：
13.5
通讯作者：
M. Alter
中科院分区：
文献类型：
--
作者：
M. Alter
丙型肝炎病毒(丙型肝炎病毒)通过经皮或经粘膜接触感染性血液或血源性体液传播。根据队列和急性病例对照研究的结果，与在美国感染丙型肝炎病毒有关的危险因素包括输血和血液制品以及来自受感染捐赠者的实体器官移植、注射毒品、职业性接触血液(主要是受污染的针棒)、受感染母亲的生育、与受感染伴侣的性行为以及多个异性伴侣。丙型肝炎病毒的医院和医源性传播主要是在暴发的情况下被认识到的，主要是由于不安全的注射做法造成的。感染丙型肝炎病毒的医护人员很少将病毒传染给患者。作为传播来源的输血和移植几乎已被消除，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感染丙型肝炎病毒的最大危险因素。其他需要广泛实施的预防战略包括减少风险、咨询和服务，以及审查和改进所有类型卫生保健环境中的感染控制做法。对于感染高危人群或需要暴露后管理的人群，应常规进行丙型肝炎病毒感染检测。没有建议对感染丙型肝炎病毒的医护人员的专业活动进行常规限制，也不应因其丙型肝炎病毒感染状况而将其排除在工作、学校、娱乐和儿童看护或其他环境之外。(《国际肝病》2002；36：S93-S98)。
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. (HEPATOLOGY 2002;36:S93‐S98).