Transmission of hepatitis C can be prevented in several ways.
Prevention programs aim at needle sharing among drug addicts. Needle exchange programs and education have reduced transmission of hepatitis C infection. However IV drug users are a difficult to reach population, and rates of hepatitis C remain high among them. Among healthcare workers, safe needle-usage techniques have been developed to reduce accidental needle-sticks. Newer needle systems prevent manual recapping of needles after use of syringes, which is a frequent cause of accidental needle-sticks There is no clear way to prevent transmission of hepatitis C from mother to fetus at this time. People with multiple sexual partners should use barrier precautions such as condoms to limit the risk of hepatitis C and other sexually transmitted diseases, including HIV. If one partner is infected, monogamous couples may want to consider the low risk of transmission of hepatitis C infection when deciding whether to use condoms during sex. Some couples may decide to use them and some may not. Screening of the blood supply has almost eliminated the risk of transmission of hepatitis C infection through transfusion. People with hepatitis C infection should not share razors or toothbrushes with others because of the possibility that these items may be contaminated with blood. People who want to get a body piercing(s) or tattoo(s) are encouraged to do so only at licensed piercing and tattoo shops (facilities), and verify that the body piercing or tattoo shop uses infection-control practices.
It is critical that physicians and clinics follow manufacturers and regulatory agency directions for sterilizing/cleaning instruments and that disposable instruments be discarded properly. There is no need to use special isolation procedures when dealing with hepatitis C infected patients.
What is the prognosis of hepatitis C?
In general, among patients with untreated hepatitis C:
- 75% to 85% become chronically infected,
- 60% to 70% develop liver disease,
- 5% to 20% develop cirrhosis, and
- 1% to 5% will die from complications such as cirrhosis or liver cancer.
Drinking alcohol and acquiring other hepatitis viruses are risk factors for worse liver disease. People with chronic hepatitis C should avoid drinking alcohol and should be screened for antibodies to hepatitis A and B. If they do not have antibodies, they should be vaccinated against these other hepatitis viruses.
People with hepatitis C should be educated about preventing HIV infection. Infection with both HIV and hepatitis C speeds up and worsens liver damage caused by the hepatitis C. Hepatitis C also can affect the HIV infection and how it is treated. About 25% of people with HIV infection are co-infected (also infected) with hepatitis C, and up to 90% of IV drug users with HIV are co-infected with hepatitis C. Screening for hepatitis viruses is important in all people infected with HIV, just as screening for HIV is important in people who have hepatitis C.
Liver cancer (hepatocellular carcinoma, or hepatoma) is associated with cirrhosis from chronic hepatitis C. Some experts recommend screening patients with hepatitis C infection and cirrhosis for liver cancer periodically.