| Volume
1 – Transmission of Hepatitis C Virus (HCV) |
| August
10, 2004 |
How
did I get this disease?
Frequently no one
can tell exactly when and how a patient acquired HCV, although there is
usually an exposure history that points to the most likely period of time
and the most likely source of transmission. For example, if a patient
had a blood transfusion in early 1980s, in the absence of any other risks,
this is the most likely route and time of transmission.
What
are the risk factors for contracting HCV?
These are the most
common routes of transmission of hepatitis C virus:
- intravenous drug
use
- transfusion of
blood and blood products
- occupational exposure
to blood (primarily during contaminated needle stick injuries)
- sexual transmission
- vertical transmission
(from mother to child)
I
have hepatitis C. My daughter-in-law is afraid to let me hold or kiss
my grandson, age 1. This breaks my heart. Am I infectious?
Transmission occurs
by blood-to-blood contact. Casual contact such as hugging, kissing, and
holding hands are safe activities for people with HCV.
Is
it OK to kiss?
There is no scientific
evidence to suggest that hepatitis C is transmitted through kissing; therefore
kissing is OK. We suggest avoidance of kissing if one of the two individuals
has a sore or open lesion in the mouth or on the lips.
Can
I pass this disease to others by kissing or sexual intercourse?
The only way of transmitting
hepatitis C in a kiss would be for two people with actively bleeding areas
to kiss and exchange blood that way. You can pass this disease to others
by sexual intercourse, although this is uncommon. The CDC does not recommend
any change in sexual practice (e.g. barrier protection) for monogamous
patients involved in long-term relationships. The more sexual partners
one has and the "rougher" the sexual practice, the more the
theoretical likelihood of having two open lesions.
My
husband has hepatitis C, and I am afraid on contracting it from him. We
have been married for 16 years.
There is much good
news in the answer. While the risk of becoming infected with hepatitis
C through sexual relations is not zero, it is very, very low. It is so
low, in fact, that most of us who treat patients with hepatitis C hardly
ever see sexual partners who are both infected (unless there is some other
shared risk such as illicit intravenous drug use). The situation for hepatitis
C is much different than it is for hepatitis B, which is much more likely
to be transmitted sexually. The Centers for Disease Control and Prevention
(CDC) is a federal agency whose responsibility is to protect the public
from communicable diseases. They advise that when one partner in a stable
one-partner relationship has hepatitis C, there is no need for any change
in sexual practice at all. The partner should be informed about the presence
of hepatitis C. In the event there are multiple sexual partners, the practice
of "safe sex" is recommended.
I
have body piercing and tattoos. Do I have HCV?
Most tattoo parlors
and body piercing establishments are now regulated by the state and must
meet hygenic standards. However, you should be tested for hepatitis B
and C.
I
never had a blood transfusion or used needles, so where did I get HCV?
Sources of infection
include tattoos, body piercings, unprotected sex, surgical procedures.
In a substantial number of cases, the source is not known. With
careful history taking, the majority of patients will identify a potential
risk/source for transmission of HCV. Nevertheless, up to 10% of patients
cannot identify a potential source for HCV transmission or any potential
risks for acquiring HCV.
Can
mosquitoes transmit HCV from one person to another? Is there any study
on this mode of transmission?
There is no definite
evidence suggesting that mosquitoes can transmit HCV. Theoretically, it
is possible that an insect feeding on the blood of an infected individual
might transmit the virus to others. At the moment, there is no evidence
to indicate that HCV is a mosquito-borne disease.
Is
it OK to eat from the same plate used by a person with HCV?
It is fine to eat
from the same plate. This will not cause transmission of HCV.
What
are the risks of giving HCV to the children, from either the mother or
father?
The chance is very
slim. Although there are cases of HCV transmission from an infected mother
to her newborn infant, these are uncommon (less than 6% of pregnancies
in the setting of HCV). Transmission from the parent to child during normal
contact has not been reported and is not likely to occur.
Should
I tell my wife about this infection?
The risk of HCV transmission
is low in those in a monogamous relationship. The Centers for Disease
Control advises informing sexual partners of your HCV status. As previously
stated, no change in sexual practice is recommended for those in a stable
monogamous relationship. Although not universally recommended, some experts
do suggest screening a patient's spouse for hepatitis C.
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