Unsafe injection: an important channel of hepatitis C transmission

  Recently, at the 2nd Asia-Pacific Frontier Forum on Liver Diseases, Zhuang Hui, an academician of the Chinese Academy of Engineering, said that there are about 10 million cases of hepatitis C infection in China, and the number of hepatitis C cases reported each year is increasing year by year. The traditional belief is that the transmission channels of hepatitis C include blood transfusion, drug users mixing syringes, and high-risk sexual behavior. In recent years, it has been found that unsafe injections are also a route of hepatitis C transmission, which should be of great concern to clinicians and patients.  The number of hepatitis C cases has increased seven-fold in eight years In recent years, the number of hepatitis C cases in China has increased year by year, with more than 170,000 hepatitis C cases reported in 2011, a seven-fold increase in eight years compared to the number of cases in 2003. Academician Zhuang Hui said, “The prevalence of hepatitis C has become a serious public health problem in China, but the current awareness of the disease among the public and non-infectious physicians is relatively low.”  According to a 2006 epidemiological survey, the prevalence of hepatitis C in China was 0.43 percent, with about 5.6 million patients, but this figure far underestimates the actual number of hepatitis C cases. Zhuang Hui said this data is from 160 disease surveillance sites and is part of the general population prevalence rate. But surveys in recent years have found that in certain regions, such as Heyuan in Guangdong, Putian in Fujian and Kuancheng in Hebei, the prevalence of hepatitis C among the general population is much higher than the national prevalence. The reasons for this are mostly due to unsafe injections and sharing of syringes leading to the spread of hepatitis C virus in the population. In recent years, there have been several cases of hepatitis C transmission due to unsafe injections in China, which should be given high priority.  Nosocomial infection has become a new route of infection, and hepatitis C is characterized by high insidiousness, high underdiagnosis and high chronicity. The director of the Department of Hepatology at Peking University Hospital, Wei Lai, said that hepatitis C has a long incubation period, the symptoms are relatively insidious, often without obvious symptoms and signs, 80% of acute hepatitis C patients have no obvious symptoms, up to 50%-85% of acute hepatitis C patients will turn into chronic hepatitis C if not treated. 20-30 years later, some chronic patients unknowingly developed into serious cirrhosis or even liver cancer. Therefore, hepatitis C is known as the “silent killer”.  Currently, there is no vaccine to prevent hepatitis C. Once infected with the virus, only 20% of patients are able to clear the virus spontaneously, and most people infected with hepatitis C are carriers. In the HIV (AIDS-infected) population, the infection rate of hepatitis C is 60%-90%; among hemodialysis patients, 20%-50% suffer from hepatitis C.  In addition, dental, endoscopic, interventional and surgical procedures are all important ways of contracting hepatitis C in hospitals. Wei Lai believes that public and physician education on hepatitis C awareness must be enhanced, and high-risk groups should be screened regularly with a view to early detection, diagnosis and treatment.  Although hospitals now test patients for hepatitis C, hepatitis B, AIDS, syphilis and other infectious diseases before surgery, the lack of a systematic system for preventing and treating hepatitis C. If non-infectious doctors are not sufficiently aware of hepatitis C prevention and treatment, it often results in missed diagnoses and underreporting in hospitals, making patients miss the best time for treatment.  Early treatment, 80% of hepatitis C can be cured for hepatitis C, the public should strengthen the awareness of early detection, once diagnosed with hepatitis C is not necessary to panic, because as long as early treatment, it is a curable disease.  High-risk groups should raise awareness of self-care and regular screening, and once diagnosed, patients should receive standardized antiviral treatment under the guidance of a specialist for the best treatment outcome. The Chinese guidelines for the prevention and treatment of hepatitis C clearly state that long-acting interferon combined with ribavirin is currently one of the preferred treatment options for hepatitis C. The combination of pegylated interferon and ribavirin can achieve a cure rate of 70% to 80% with a full course of treatment.