Hepatitis C risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-In-Chief: Nina Axiotakis [2]

Risk Factors

  • Intravenous drug users (IVDU)
  • Blood transfusion before 1990
    • Current transfusion-associated risk: < 1/100,000
    • Comparative risks: Hepatitis B Virus (HBV) 1/63,000, HIV 1/493,000
    • Residual risk due to recently infected donors (10 week window)
  • Percutaneous exposures
    • Needle stick transmission: ~3% HCV, 30% HBV, 0.3% HIV
  • Lesser Risk Factors
    • High-risk sexual behavior
    • Low socioeconomic status (unclear mechanisms)
      • Sexual transmission inefficient
      • HIV coinfection increases sexual and maternal-fetal transmission
  • Risk Factors For Progression
    • EtOH use
    • HIV or HBV coinfection
    • Older age at infection, male sex
  • Number of new infections per year has declined from an average of 240,000 in the 1980s to about 26,000 in 2004.
  • Most infections are due to illegal injection drug use.
  • Transfusion-associated cases occurred prior to blood donor screening; now occurs in less than one per 2 million transfused units of blood.
  • Estimated 4.1 million (1.6%) Americans have been infected with HCV, of whom 3.2 million are chronically infected.
  • The risk for perinatal HCV transmission is about 4%
  • If coinfected with HIV the risk for perinatal infection is about 19%

References

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