This second issue of Hot Topics in Viral Hepatitis focuses on the transmission of hepatitis C virus (HCV)—primarily on the less common, but not less important, routes of infection.
Following the introduction of screening assays in blood banking, the transmission of posttransfusion HCV has virtually disappeared. Thus, in developed countries where iatrogenic HCV infections via unsafe, invasive medical procedures have become uncommon, the primary cause of contamination with HCV in the pediatric population is transmission from an infected mother. The first article, which reports on the impact of mother-to-child transmission, provides a complete and critical overview about the risk factors of transmission and the appropriate clinical counseling in this very sensitive setting.
The next topic that is addressed is the problem of nosocomial infections still occurring, often in the form of microepidemics, among patients who undergo hemodialysis, a rather vulnerable population. Breaches in standard procedures are responsible for most cases of blood-borne transmission in dialysis units. It is only due to HCV’s relatively weak resistance to the environment that there aren’t more outbreaks.
Finally, a thorough review is provided on some more “exotic” and somehow controversial routes of HCV transmission, from tattoos to body piercing, and from acupuncture to ritual procedures, such as scarification, blood brother/sister rituals, and circumcision. Although the data are quite scant for many of these maneuvers, their role in transmitting HCV, at least under certain circumstances of poor hygiene and little awareness, is very likely and should prompt the implementation of appropriate preventive measures, despite the expected cultural hurdles.
A fascinating topic, for the physician as well as for the anthropologist! I trust that you will find this last entry in HCV transmission a very exciting read, and one that perhaps will spark further research.