title: Health care-associated hepatitis C virus infection.
abstract: Hepatitis C virus (HCV) is a blood-borne pathogen that has a worldwide distribution and infects millions of people. Care-associated HCV infections represented a huge part of hepatitis C burden in the past via contaminated blood and unsafe injections and continue to be a serious problem of public health. The present review proposes a panorama of health care-associated HCV infections via the three mode of contamination that have been identified: (1) infected patient to non-infected patient; (2) infected patient to non-infected health care worker (HCW); and (3) infected HCW to non infected patient. For each condition, the circumstances of contamination are described together with the means to prevent them. As a whole, the more important risk is represented by unsafe practices regarding injections, notably with the improper use of multidose vials used for multiple patients. The questions of occupational exposures and infected HCWs are also discussed. In terms of prevention and surveillance, the main arm for combating care-associated HCV infections is the implementation of standard precautions in all the fields of cares, with training programs and audits to verify their good application. HCWs must be sensitized to the risk of blood-borne pathogens, notably by the use of safety devices for injections and good hygiene practices in the operating theatre and in all the invasive procedures. The providers performing exposed-prone procedures must monitor their HCV serology regularly in order to detect early any primary infection and to treat it without delay. With the need to stay vigilant because HCV infection is often a hidden risk, it can be hoped that the number of people infected by HCV via health care will decrease very significantly in the next years.
authors.affiliation: Bruno Pozzetto, Meriam Memmi, Olivier Garraud, Xavier Roblin, Philippe Berthelot, Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP EA3064), Faculty of Medecine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pozzetto
authors.affiliation: Bruno Pozzetto, Meriam Memmi, Olivier Garraud, Xavier Roblin, Philippe Berthelot, Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP EA3064), Faculty of Medecine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France.
authors.forename: Meriam
authors.initials: M
authors.lastname: Memmi
authors.affiliation: Bruno Pozzetto, Meriam Memmi, Olivier Garraud, Xavier Roblin, Philippe Berthelot, Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP EA3064), Faculty of Medecine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Garraud
authors.affiliation: Bruno Pozzetto, Meriam Memmi, Olivier Garraud, Xavier Roblin, Philippe Berthelot, Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP EA3064), Faculty of Medecine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Roblin
authors.affiliation: Bruno Pozzetto, Meriam Memmi, Olivier Garraud, Xavier Roblin, Philippe Berthelot, Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP EA3064), Faculty of Medecine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Berthelot
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission* / Q000821:virology; D042241:Early Diagnosis; D007722:Health Knowledge, Attitudes, Practice; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission* / Q000821:virology; D006801:Humans; D017053:Infection Control / Q000379:methods; D017758:Infectious Disease Transmission, Patient-to-Professional; D017757:Infectious Disease Transmission, Professional-to-Patient; D016273:Occupational Exposure / Q000009:adverse effects*; D016272:Occupational Health; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012698:Serologic Tests; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
keywords: Antiviral drugs; Health care worker; Health care-associated infection; Hemodialysis; Hepatitis C virus; Occupational exposure; Standard precautions; Unsafe injections