Counselling patients with hepatitis C

Hepatitis C virus (HCV) is usually but not exclusively transmitted by the p arenteral route. Some precautions are recommended for infected patients as web as his/ her close contacts and family members. The risk of sexual trans mission and from household contacts is very low: Use of condoms is only rec ommended in cases of multiple partners and for those at high risk of transm ission. Some personal objects should not be shared, i.e. razors, toothbrush es and nail clippers, but it is not necessary to avoid sharing eating utens ils. Sexual partners may be tested for anti-HCV. HCV-positive individuals s hould refrain from donating blood, organs and tissue. Clear and evidenced-b ased information should be provided to patients as to the means of preventi on with special attention to individual risk groups such as IV drug abusers . The risk of HCV transmission after needlestick injury, although low justi fies universal precaution measurements for health-care workers. Nosocomial transmission has been described after medical procedures, especially haemod ialysis and endoscopy. Thus, disinfection procedures as well as universal p recautions are essential for all health-care workers. It is also important for HCV patients to inform health-care workers beforehand about their HCV s tatus. Perinatal transmission is rare and is usually related to the degree of maternal viral load. Pregnancy is not contra-indicated in HCV-infected i ndividuals and breast-feeding is allowed. Finally, HCV patients with active disease should be advised to refrain from alcohol intake, especially durin g antiviral therapy After HCV infection it is necessary to consider not onl y diagnostic and therapeutic steps but also the risk of transmission in the patient's circle and consequences for the patient.