Hepatitis C is particularly insidious because the
infection can take 20 to 30 years to progress
enough to generate symptoms. A blood test can
detect antibodies after the virus has been in the
body for about six weeks, however, and health
experts recommend that people who are at risk for
hepatitis C be tested. People at highest risk for
having hepatitis C infection are those who may
have engaged in high-risk behaviors as long as 20
or 30 years ago. About 4 million Americans have
chronic hepatitis C infection, nearly 2 percent of
the U.S. population, and epidemiologists believe
they may reflect only about 30 to 40 percent of
those who are actually infected.
Hepatitis is a significant public health issue.
Acute hepatitis sickens thousands of people each
year and can be particularly serious, even fatal, in
children and in people who are IMMUNOCOMPRO-
MISED. Chronic hepatitis is the leading cause of
LIVER FAILUREand leading reason for LIVER TRANS-
PLANTATIONin the United States. A secondary pub-
lic health concern is that a person who has had
hepatitis, or who has chronic hepatitis, cannot
donate blood. This has the potential to severely
limit the availability of blood and blood products
for transfusion.
KEY MEASURES FOR PREVENTING HEPATITIS
- Wash hands frequently with soap and warm water.
- Do not share food, drinks, or eating utensils.
- Receive the hepatitis A and hepatitis B vaccinations.
- Do not use injectable drugs.
- Use condoms during sexual intercourse, and limit sexual
partners. - Use barrier precautions (masks and gloves) to protect
against INFECTIONfrom occupational exposure. - Receive prophylactic treatment (immunoglobulin injection)
after suspected exposure.
See also SEXUALLY TRANSMITTED DISEASE(STD) PRE-
VENTION.
HIV/AIDS prevention Researchers first detected
the human immunodeficiency VIRUS (HIV) that
causes acquired immunodeficiency syndrome
(AIDS) in the early 1980s. New HIV/AIDSinfections
peaked about a decade later and have since slowly
but steadily declined to reach a point over the past
decade of holding relatively steady in the United
States at about 40,000 a year. Advances in treat-
ment, however, have resulted in increasing num-
bers of people living with HIV. Though this marks
an exciting milestone in the fight against
HIV/AIDS, it also means the risk for INFECTIONis
growing because more people are already infected.
As well, health experts worry that improved treat-
ment regimens that can forestall the transition
from an HIV-positive status to AIDS may encour-
age complacency about HIV protection. AIDS
remains ultimately fatal, and preventing infection
remains the only cure. Though medical treatments
can delay the disease’s progression, there are as
yet no treatments that can eradicate the virus.
Research continues to search for both a cure and a
VACCINE.
Prevention efforts target two dimensions of
HIV/AIDS infection, halting the spread of infection
and early diagnosis and treatment for those who
become infected. Because of the long period of
time during which a person can be infected and
not know it, health experts view early diagnosis as
a preventive measure; because most people, once
diagnosed as HIV-positive, will take the recom-
mended precautions to prevent spreading the
virus to others. People who do not know they
have HIV often do not feel the need to take signif-
icant precautions. A special focus area is prevent-
ing perinatal infection, in which an HIV-positive
woman passes the virus to her unborn child.
Preventing New Infections
A person gets HIV/AIDS from close and regular
contact with the body fluids, such as BLOODand
SEMEN, of another person who already has the
virus. Abstinence is the only certain way to pre-
vent infection via sexual activity with a partner.
Barrier methods to prevent the body fluids of one
person from contact with the mucous tissues of
the other person during sex are the most effective
approaches to reduce the risk for transmitting HIV.
Consistent use of latex condoms during sex (anal,
vaginal, and oral intercourse) significantly reduces
the risk of passing HIV from the infected partner
to the noninfected partner. People who inject
drugs and share needles and paraphernalia can
spread HIV through blood-to-blood contact. Breast
milk can also transmit the virus from mother to
infant. The average length of time from infection
32 Preventive Medicine