Hepatitis C secondary prevention
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Patients who are diagnosed with chronic hepatitis C require vaccination against other hepatitis viruses, limiting of alcohol intake, and evaluation for other comorbid conditions in order to limit further hepatic damage. Patients should be instructed on how to avoid HCV transmission to others.
Patients who are diagnosed with chronic hepatitis C require specific measures to limit further hepatic damage and to avoid progression to cirrhosis.
Important measures to avoid reduce the risk of further hepatic injury include:
- Assessment of alcohol intake for all patients with HCV infection and advising limitation of alcohol
- Behavioural alcohol reduction intervention in patients with moderate to high alcohol intake
- Maintaining a well balanced diet that is low in fat
- Evaluation for other conditions that may accelerate liver fibrosis, including HBV and HIV infections
- Immunization against other hepatitis viruses(hepatitis A and hepatitis B) is highly recommended
- Studies have demonstrated an association between treatment-induced sustained viral clearance and low extra-hepatic manifestations (such as, cryoglobulinemic vasculitis, B-cell nonHodgkin’s lymphoma, acute coronary syndrome, cardiovascular disease, insulin resistance, and type 2 diabetes) risk for Hepatitis C.
Precautions to prevent transmission to other individuals include:
- Covering completely any cut or wound with a waterproof dressing would help in reduction of transmission of the virus
- Ensuring that the injecting equipment is not shared
- Avoiding blood or organ donation
- Not sharing personal items such as toothbrushes or razors
- Engaging in protected intercourse whenever possible
There are currently no CDC recommendations to restrict a healthcare worker who is infected with HCV. The risk of transmission from an infected healthcare worker to a patient appears to be very low. All healthcare personnel, including those who are HCV positive, should follow strict aseptic technique and standard precautions, including appropriate hand hygiene, use of protective barriers, and safe injection practices.
- AASLD/IDSA/IAS–USA. Recommendations for testing, managing, and treating hepatitis C. http://www.hcvguidelines.org. Accessed July 27, 2014.
- Hsu YC, Ho HJ, Huang YT, Wang HH, Wu MS, Lin JT, Wu CY (March 2015). "Association between antiviral treatment and extrahepatic outcomes in patients with hepatitis C virus infection". Gut. 64 (3): 495–503. doi:10.1136/gutjnl-2014-308163. PMID 25398770.
- Innes HA, McDonald SA, Dillon JF, Allen S, Hayes PC, Goldberg D, Mills PR, Barclay ST, Wilks D, Valerio H, Fox R, Bhattacharyya D, Kennedy N, Morris J, Fraser A, Stanley AJ, Bramley P, Hutchinson SJ (August 2015). "Toward a more complete understanding of the association between a hepatitis C sustained viral response and cause-specific outcomes". Hepatology. 62 (2): 355–64. doi:10.1002/hep.27766. PMID 25716707.
- Cacoub P, Desbois AC, Comarmond C, Saadoun D (November 2018). "Impact of sustained virological response on the extrahepatic manifestations of chronic hepatitis C: a meta-analysis". Gut. 67 (11): 2025–2034. doi:10.1136/gutjnl-2018-316234. PMID 29703790.
- Cacoub, Patrice; Longo, Dan L.; Saadoun, David (2021). "Extrahepatic Manifestations of Chronic HCV Infection". New England Journal of Medicine. 384 (11): 1038–1052. doi:10.1056/NEJMra2033539. ISSN 0028-4793.
- World Health Organization (WHO) 2014. Guidelines for the screening, care and treatment of persons with hepatitis C infection.http://www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/. Accessed online on July 24,2014.