Hepatitis C is an infectious disease caused by persistent infection with the hepatitis C virus, or HCV. Most people do not develop symptoms and may not know they have contracted the disease. If HCV infection is left untreated some people develop symptoms of liver cirrhosis after many years and a few of these cases progress to liver cancer. The Centers for Disease Control and Prevention, or CDC, reports that HCV infection is the number one blood-borne infection in the United States and that approximately 1.8 percent of Americans have been infected with HCV. There is no vaccine to prevent HCV infection.
Transmission
The HCV infects liver cells. The World Health Organization, or WHO, reports that approximately 40 percent of those infected with HCV recover, but the other 60 percent are chronic carriers of the disease. Blood-to-blood contact spreads HCV. In the past, blood transfusion was a significant source of HCV transmission, but the CDC reports that since 1994 blood transfusions are a negligible source of HCV infection in the United States. The CDC says that currently, the primary source of HCV transmission is injection drug use, which accounts for 60 percent of HCV transmission in America.
CDC Primary Prevention
The goals of the CDC HCV prevention program are to prevent infection and decrease the complications of chronic infection. The elements included in the CDC program are separated into primary and secondary activities. The primary activities are to screen and test blood, plasma, organ, tissue and semen donors and to inactivate the virus in plasma-derived products. In May of 1990 routine testing for the presence of HCV in blood donors was initiated. In 1992 more sensitive routine testing began, and the CDC says the risk of HCV infection from blood transfusion was reduced to 0.001 percent per unit transfused. Since 1994 all immunoglobulins and other plasma-derived products have been treated to inactivate HCV prior to injection.
CDC Secondary Prevention
Secondary prevention activities supported by the CDC are to identify, counsel and test at-risk populations and provide medical treatment for those with chronic infection. At-risk populations are injection drug users, some health care workers---especially those who work in hemodialysis centers---and children born to HCV-positive women.
The CDC recommends routine testing and exposure prevention education with counseling of high-risk groups. The WHO reports that in more than 60 percent of people infected with HCV, chronic liver disease develops and of these patients between 5 and 20 percent develop severe scarring of the liver, known as cirrhosis. The WHO also says that the occurrence of liver cancer in people who are chronically infected with HCV is between 1 and 5 percent. The secondary prevention programs of the CDC aim to reduce the number of infected individuals that develop liver disease by medical monitoring and antiviral therapy. In addition to these activities, the CDC provides public education and evaluates its prevention strategies for their effectiveness.
World Hepatitis Alliance
The World Hepatitis Alliance is a worldwide advocacy group that has lobbied for a worldwide prevention program for viral hepatitis. In 2010 the World Health Assembly, supported by 193 member states, agreed on a framework to improve the prevention, diagnosis and treatment of viral hepatitis. In 2009, this group, in partnership with the WHO developed "Viral Hepatitis: Global Policy" which provides an overview of program strategies for viral hepatitis of member countries.
