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Public Health and Hepatitis C

L’hépatite C et la santé publique

  • Published: 01 July 2000
  • Volume 91, pages S19–S23, (2000)
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Canadian Journal of Public Health Aims and scope Submit manuscript
Public Health and Hepatitis C
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  • David M. Patrick1,
  • Jane A. Buxton1,
  • Mark Bigham1 &
  • …
  • Richard G. Mathias1 

  • 109 Accesses

  • 6 Citations

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Abstract

This paper reviews key public health aspects related to surveillance, transmission and primary prevention of hepatitis C. Hepatitis C is now a reportable disease in all Canadian provinces and territories. Although prevalence in Canada is estimated at under 1%, that associated with injection drug use (IDU) approaches 90%. The epidemiology of new HCV infections in Canada is now primarily defined by IDU behaviour, with annual incidence rates among new drug injectors exceeding 25%. HCV is less efficiently transmitted through other routes of exposure. An effective vaccine against HCV remains elusive. Some jurisdictions offer hepatitis A and hepatitis B vaccine to HCV-infected persons. An array of harm reduction strategies targeting IDU has been implemented but underdeployed across Canada, and has been ineffective to date in controlling the HCV epidemic. Public policy alternatives, such as legalization and regulation of injection drugs, are being debated. Improved HCV preventive strategies are urgently required and need careful evaluation.

Résumé

La présente communication passe en revue les principaux aspects de la santé publique liés à la surveillance, à la transmission et à la prévention primaire de l’hépatite C. Aujourd’hui, au Canada, cette infection doit être déclarée dans toutes les provinces et dans tous les territoires. Bien que sa prévalence dans notre pays soit évaluée à moins de 1 %, celle qui est associée à l’utilisation de drogues injectables (UDI) est proche de 90 %. L’épidémiologie des nouvelles infections par le VHC au Canada se définit maintenant surtout par le comportement des UDI et les taux annuels d’incidence parmi les nouveaux utilisateurs de drogues injectables sont supérieurs à 25 %. Le VHC se transmet moins efficacement par d’autres voies d’exposition. La mise au point d’un vaccin efficace contre le VHC paraît impossible à l’heure actuelle. Certaines provinces vaccinent les personnes atteintes du VHC contre l’hépatite A et l’hépatite B. Plusieurs stratégies de réduction des préjudices attribuables à l’UDI ont été instituées au Canada, mais leur portée n’est pas suffisante et elles n’ont pas permis, jusqu’à présent, d’enrayer l’épidémie du VHC. On envisage actuellement des solutions sur le plan de la politique publique, notamment la légalisation et la réglementation des drogues injectables. Il est urgent de trouver de meilleures stratégies de prévention du VHC et de les évaluer soigneusement.

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Références

  1. LCDC. Hepatitis C–Prevention and control: A public health consensus. CCDR 1999;25S2:1–23.

    Google Scholar 

  2. Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR 1998;47:RR–19.

    Google Scholar 

  3. Division de la surveillance des maladies, Laboratoire de lutte contre la maladie, Santé Canada.

  4. Remis RS. Group HCW. Estimating the number of blood transfusion recipients infected by hepatitis C virus in Canada, 1960–1985 and 1990–1992. Dans: The report of the expert panel on hepatitis C. Toronto: Secrétariat canadien du sang, Santé Canada, 1998.

    Google Scholar 

  5. Manuel DG, Johnson I, Fearon M, Hockin J. The prevalence of hepatitis C in a community based population, Ontario, 1996. CCDR 1999;25-23:193–99.

    Google Scholar 

  6. LCDC. Preventing the transmission of blood-borne pathogens in health care and public service settings. CCDR 1997;23S3.

  7. Liou TC, Chang TT, Young KC, et coll. Detection of HCV RNA in saliva, urine, seminal fluid and ascites. J Med Virol 1992;37(3):197–202.

    CAS  PubMed  Google Scholar 

  8. Wang JT, Wang TH, Sheu JC, et coll. Hepatitis C virus RNA in saliva of patients with posttransfusion hepatitis and low efficiency of transmission among spouses. J Med Virol 1992;36(1):28–31.

    CAS  PubMed  Google Scholar 

  9. Mahajan L, Wyllie R, Steffen R, Kay M. Mother-to-infant transmission of hepatitis C virus and breast-feeding. [comment] J Pediatrics 1995;127(4):670–71.

    CAS  Google Scholar 

  10. Zanetti AR, Tanzi E, Newell ML. Mother-to-infant transmission of hepatitis C virus. J Hepatol 1999;31 Suppl 1:96–100.

    PubMed  Google Scholar 

  11. European Collaborative Study. Risk factors for mother-to-child transmission of HIV-1. Lancet 1992;339:1007–12.

    Google Scholar 

  12. LCDC, Health Canada, Sentinel Health Unit Surveillance System (1994).

    Google Scholar 

  13. Crofts N, Jolley D, Kaldor J, et coll. Epidemiology of hepatitis C virus infection among injection drug users in Australia. J Epidemiol Community Health 1997;51:692–97.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. The VIDUS project update #5, septembre 1999.

  15. Patrick DM, Cornelisse PGA, Sherlock CH, et coll. Hepatitis C prevalence and incidence in Vancouver IDUs. Septième congrès annuel de l’Association canadienne de recherche sur le VIH, Québec (Quebec), Canada, Avril-mai 1998. Can J Infect Dis 1998; 9 (Suppl A): Résumé C236.

    Google Scholar 

  16. Garfein RS, Vlahov D, Galai N, et coll. Viral infections in short-term injection drug users: The prevalence of the hepatitis C, hepatitis B, human immunodeficiency and human T-lymphotropic viruses. Am J Public Health 1996;86:655–61.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Frank C, Mohamed M, Strickland GT, et coll. The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt. Lancet 2000;355(9207):887–91.

    CAS  PubMed  Google Scholar 

  18. Alter MJ. Hepatitis C virus infection in the United States. J Hepatol 1999;31 (Suppl 1):88–91.

    PubMed  Google Scholar 

  19. Kleinman SH. Incidence/Window Period Model. Transf Med Rev 1997;11:155–72.

    CAS  Google Scholar 

  20. Committee on Infectious Diseases, American Academy of Pediatrics. 1997 Red Book: Report of the Committee on Infectious Diseases. Elk Grove Village, IL: American Academy of Pediatrics, 1997;75.

  21. Zanetti AR, Tanzi E, Paccagnini S, et coll. Mother-to-infant transmission of hepatitis C virus. Lancet 1995;345:289–91.

    CAS  PubMed  Google Scholar 

  22. Resti M. Mother-to-infant transmission of hepatitis C virus. Ital J Gastroenterol Hepatol 1999;31:489–93.

    CAS  PubMed  Google Scholar 

  23. Tovo P-A, Newell M-L. Hepatitis C in children. Curr Opinion in Infect Dis 1999;12:245–50.

    CAS  Google Scholar 

  24. Thomas SL, Newell ML, Peckham CS, et coll. A review of hepatitis C virus (HCV) vertical transmission: Risk of transmission to infants born to mothers with and without HCV viraemia or human immunodeficiency virus infection. Int J Epidemiol 1998;27:108–17.

    CAS  PubMed  Google Scholar 

  25. Resti M, Azzari C, Mannelli F, et coll. Mother to child transmission of hepatitis C virus: Prospective study of risk factors and timing of infection in children born to women seronegative for HIV-1. Tuscany Study Group on Hepatitis C Virus Infection. BMJ 1998;317:437–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Lin H-H, Kao J-H, Hsu H-Y, et coll. Absence of infection in breast-fed infants born to hepatitis C virus-infected mothers. [see comment] J Pediatrics 1995;126(4):589–91. Comment in: J Pediatrics 1995;127(4):670–71.

    CAS  Google Scholar 

  27. Kumar RM, Shahul S. Role of breast-feeding in transmission of hepatitis C virus to infants of HCV-infected mothers. J Hepatol 1998;29:191–97.

    CAS  PubMed  Google Scholar 

  28. Garland SM, Tabrizi S, Robinson P, et coll. Hepatitis C - Role of perinatal transmission. Aust NZ J Obstet Gynaecol 1998;38(4):424–27.

    CAS  Google Scholar 

  29. Caporaso N, Ascione A, Stroffolini T. Spread of hepatitis C virus infection within families. Investigators of an Italian Multicenter Group. J Viral Hepatol 1998;1:67–72.

    Google Scholar 

  30. Guadagnino V, Stroffolini T, Foca A, et coll. Hepatitis C virus infection in the family setting. Eur J Epidemiol 1998;14(3):229–32.

    CAS  PubMed  Google Scholar 

  31. Sagnelli E, Gaeta GB, Felaco FM, et coll. Hepatitis C virus infection in households of anti-HCV chronic carriers in Italy: A multicentre case-control study. Infection 1997;25(6):346–49.

    CAS  PubMed  Google Scholar 

  32. Diago M, Zapater R, Tuset C, et coll. Intrafamily transmission of hepatitis C virus: Sexual and nonsexual contacts. J Hepatol 1996;25(2):125–28.

    CAS  PubMed  Google Scholar 

  33. Hou CH, Chen WY, Kao JH, et coll. Intrafamilial transmission of hepatitis C virus in hemodialysis patients. J Med Virol 1995;45(4):381–85.

    CAS  PubMed  Google Scholar 

  34. Demalia L, Vallebona E, Poima R, et coll. HCV transmission in family members of subjects with HCV related chronic liver disease. Eur J Epidemiol 1996;12(1):45–50.

    Google Scholar 

  35. Papanastasiou DA, Spiliopoulou I, Katinakis S, et coll. Lack of transmission of hepatitis C in household contacts of children with homozygous beta-thalassaemia. Acta Haematol 1997;97(3):168–73.

    CAS  PubMed  Google Scholar 

  36. Dienstag JL. Sexual and perinatal transmission of hepatitis C. Hepatology 1997;3 Suppl 1:66S–70S.

    Google Scholar 

  37. Tanaka K, Stuver So, Ikematsu H, et coll. Heterosexual transmission of hepatitis C virus among married couples in southwestern Japan. Int J Cancer 1997;72(1):50–55.

    CAS  PubMed  Google Scholar 

  38. Nakashima K, Ikematsu H, Hayashi J, et coll. Intrafamiliar transmission of hepatitis C virus among the population of an endemic area of Japan. JAMA 1995;274:1459–61.

    CAS  PubMed  Google Scholar 

  39. Meisel H, Reip A, Faltus B, et coll. Transmission of hepatitis C virus to children and husbands by women infected with contaminated anti-D immunoglobulin. Lancet 1995;345:1209–11.

    CAS  PubMed  Google Scholar 

  40. Kumar RM. Interspousal and interfamilial transmission of hepatitis C virus: A myth or a concern? Obstetrics and Gynecology 1998;91(3):426–31.

    CAS  PubMed  Google Scholar 

  41. Akahane Y, Kojima M, Sugai Y, et coll. Hepatitis C virus infection in spouses of patients with type C chronic liver disease. Ann Intern Med 1994;120(9):748–52.

    CAS  PubMed  Google Scholar 

  42. Coltorti M, Caporaso N, Morisco F, et coll. Prevalence of hepatitis C virus infection in the household contacts of patients with HCV-related chronic liver disease. Infection 1994;22(3):183–86.

    CAS  PubMed  Google Scholar 

  43. Abildgaard N, Peterslund NA. Hepatitis C virus transmitted by a tattooing needle. Lancet 1991;338:460.

    CAS  PubMed  Google Scholar 

  44. Shimokura GH, Gully PR. Risk of hepatitis C virus infection from tattooing and other skin piercing services. Can J Infect Dis 1995;6(5):235–38.

    CAS  PubMed  PubMed Central  Google Scholar 

  45. Vento S, Garfano T, Renzini C, et coll. Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C. N Engl J Med 1998;338:286–90.

    CAS  PubMed  Google Scholar 

  46. Comité consultatif national de l’immunisation. Guide canadien d’immunisation, 5e édition, 1998. Ottawa, ON: Santé Canada, 1998. (Ministre des Travaux publics et des Services gouvernementaux, Canada, Cat no.H49-8/998E.)

    Google Scholar 

  47. Weiner AJ, Brauer MJ, Rosenblatt J, et coll. Variable and hypervariable domains are found in the regions of HCV corresponding to the fla-vivirus envelope and NSI proteins and the pes-tivirus envelope glycoproteins. Virology 1991;180:842–48.

    CAS  PubMed  Google Scholar 

  48. Kato N, Ootsuyama Y, Ohkoshi S, et coll. Characterization of hypervariable regions in the putative envelope protein of hepatitis C virus. Biochem Biophys Res Commun 1992;189:119–27.

    CAS  PubMed  Google Scholar 

  49. Kato N, Ootsuyama Y, Tanaka T, et coll. Marked sequence diversity in the putative envelope proteins of hepatitis C viruses. Virus Res 1992;22:107–23.

    CAS  PubMed  Google Scholar 

  50. Weiner AJ, Geysen HM, Christopherson C, et coll. Evidence for immune selection of hepatitis C virus (HCV) putative envelope glycoprotein variants: Potential role in chronic HCV infections. Proc Natl Acad Sci USA 1992;89:3468–72.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Minton EJ, Smillie D, Neal KR, et coll. Association between MHC class II alleles and clearance of circulating hepatitis C virus. J Infect Dis 1998;178:39–44.

    CAS  PubMed  Google Scholar 

  52. Lechmann M, Ihlenfeldt HG, Braunschweiger I, et coll. T- and B-cell responses to different hepatitis C virus antigens in patients with chronic hepatitis C infection and in healthy anti-hepatitis C virus-positive blood donors without viremia. Hepatology 1996;24:790–95.

    CAS  PubMed  Google Scholar 

  53. Diepolder HM, Zachoval R, Hoffmann RM, et coll. Possible mechanism involving T-lymphocyte response to non-structural protein 3 in viral clearance in acute hepatitis C virus infection. Lancet 1995;346:1006–7.

    CAS  PubMed  Google Scholar 

  54. Missale G, Bertoni R, Lamonaca V, et coll. Different clinical behaviors of acute hepatitis C virus infection are associated with different vigor of the anti-viral cell-mediated immune response. J Clin Invest 1996;98:706–14.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Tsai SL, Liaw YF, Chen MH, et coll. Detection of type 2-like T-helper cells in hepatitis C virus infection: Implications for hepatitis C virus chronicity. Hepatology 1997;25:449–58.

    CAS  PubMed  Google Scholar 

  56. Diepolder HM, Gerlach JT, Zachoval R, et coll. Immunodominant CD4+ T-cell epitope within nonstructural protein 3 in acute hepatitis C virus infection. J Virol 1997;71:6011–19.

    CAS  PubMed  PubMed Central  Google Scholar 

  57. Choo QL, Kuo G, Ralston R, et coll. Vaccination of chimpanzees against infection by the hepatitis C virus. Proc Natl Acad Sci USA 1994;91:1294–98.

    CAS  PubMed  PubMed Central  Google Scholar 

  58. Krawcynski K, Alter MJ, Tankersley DL, et coll. Effect of immune globulin on the prevention of experimental hepatitis C virus infection. J Infect Dis 1996;173(4):822–28.

    Google Scholar 

  59. Van den Hoek JAR, van Haastrecht HJA, Goudsmit J, et coll. Prevalence, incidence and risk factors of Hepatitis C virus infection among drug users in Amsterdam. J Infect Dis 1990;162:823–26.

    PubMed  Google Scholar 

  60. Fisher DG, Fenaughty AM, Paschane AA, et coll. Hepatitis C virus infection among Alaskan drug users. Am J Public Health 1997;87(10):1722–24.

    CAS  PubMed  PubMed Central  Google Scholar 

  61. McCruden EAB, Hillan KJ, McKay IC, et coll. Hepatitis virus infection and liver disease in injecting drug users who died suddenly. J Clin Pathol 1996;49:552–55.

    CAS  PubMed  PubMed Central  Google Scholar 

  62. Romanowski B, Campbell PJ, Preiksaitis JK, Fonseca K. Human immunodeficiency virus sero-prevalence and risk behaviours in patients attending sexually transmitted disease clinics in Alberta. Sex Transm Dis 1997;24(8):487–94.

    CAS  PubMed  Google Scholar 

  63. Garfein RS, Doherty MC, Monterroso ER, et coll. Prevalence and incidence of Hepatitis C virus infection among young adult injection drug users. J Acquir Immune Defic Syndr 1998; (Suppl 1):S11–S19.

  64. Moyer LA, Mast EE, Alter MI. Hepatitis C: Part II. Prevention, counselling and medical evaluation. Am Fam Phys 1999;59(2):349–54.

    CAS  Google Scholar 

  65. Leshner AI, Koob GF. Drugs of abuse and the brain. Proc Assoc Am Physicians 1999;111(2):99–108.

    CAS  PubMed  Google Scholar 

  66. DuPont RL, Voth EA. Drug legalization, harm reduction, and drug policy. Ann Intern Med 1995;123(6):461.

    CAS  PubMed  Google Scholar 

  67. Schwartz RH. Legalization of drugs of abuse and the pediatrician. Am J Dis Child 1991;145(10):1153–58.

    CAS  PubMed  Google Scholar 

  68. Millman RB. Pharmacology of the drugs of abuse and the development of public policy. Mt Sinai J Med 1991;58(5):416–20.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Communicable Disease Epidemiology Services, UBC Centre for Disease Control, 655 W 12 Ave, Bureau 2104, Vancouver, BC, V5Z 4R4, Canada

    David M. Patrick, Jane A. Buxton, Mark Bigham & Richard G. Mathias

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  1. David M. Patrick
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  2. Jane A. Buxton
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Correspondence to David M. Patrick.

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L’hépatite C et la santé publique

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Patrick, D.M., Buxton, J.A., Bigham, M. et al. Public Health and Hepatitis C. Can J Public Health 91 (Suppl 1), S19–S23 (2000). https://doi.org/10.1007/BF03405102

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  • Published: 01 July 2000

  • Issue Date: July 2000

  • DOI: https://doi.org/10.1007/BF03405102

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