Hepatitis C

Clinical picture

The hepatitis C virus (HCV) can cause inflammation of the liver (hepatitis).

The majority of acute HCV infections occur without or with only mild non-specific symptoms. Only 30-50% report fatigue, mild flu-like symptoms, nausea, vomiting, dark urine and/or discoloured faeces and abdominal pain. Without treatment, 15-40% of HCV-infected patients manage to lose the virus within 6 months. The remaining 60-85% become chronic carriers of the virus.

Additional information from the RIVM.

Infection route

Hepatitis C infection occurs through blood on blood contact and blood on mucous membrane contact (blood-contaminated bodily fluids on non-intact skin), needle stick, bite, cut or splash incidents.

Contagious period

The blood of an HCV-infectee is infectious as long as there is a demonstrable virus (HCV-RNA) in the blood. This may already be the case one week after the infection.

Incubation time

Time between contamination and symptoms: on average 7 weeks, spread of 2-26 weeks.

Potential infectees

Staff who may become occupationally infected with HCV (bodily fluids, patient material, needle stick, bite, cut or splash incidents).

More specific information on vulnerable groups can be found at www.kiza.nl.

 

Prevention

Training: Staff should be properly informed about HCV infections and the prevention of contamination by needle stick, cut, or splash incidents.

General measures: Follow the internal hygiene instructions.

Preference is given to safe puncture systems in which the used needle is (automatically) protected. Needle cups where the needle is easily and safely separated from the syringe by a slot in the lid or discarded. Never recap (never put the needle back in the sleeve). Use disposable gloves and, in conditions where drops or mist spread through the air, consider a face shield and barrier aprons.

Vaccination: there is no vaccine available against the hepatitis C virus.

Post-exposure policy

Every institution where staff may be exposed to the HCV must have a protocol for needle stick, cut, splash and bite incidents which provides that an employee can consult an expert 24 hours a day for a risk assessment of the incident and the necessary follow-up steps. The RIVM has a national needle stick incident guideline.

Potential infectors

No national policy.