Epidemiology and Prevalence

HCV is endemic in most parts of the world. Approximately 3% (200 million) of the world's population is infected with HCV (15). For many countries, no reliable prevalence data exist.

Seroprevalence studies conducted among blood donors have shown that the highest prevalence exists in Egypt (17-26%). This has been ascribed to contaminated needles used in the treatment of schistosomiasis conducted between the 1950s and the 1980s (16).

Intermediate prevalence (1-5%) exists in Eastern Europe, the Mediterranean, the Middle East, the Indian subcontinent, and parts of Africa and Asia. In Western Europe, most of Central America, Australia, and limited regions in Africa, including South Africa, the prevalence is low (0.2-0.5%). Previously, America was included in the low prevalence group, but a report published in 2003 (17) indicated that almost 4 million Americans (i.e., 1.8% of the population) have antibody to HCV, representing either ongoing or previous infection. It also states that HCV accounts for approx 15% of acute viral hepatitis in America.

The lowest prevalence (0.01-0.1%) has been found in the United Kingdom and Scandinavia. However, within any country, there are certain groups

Management After High-Risk Exposure Contact in High-Risk Group or HBsAg-Positive Person With High-Risk Exposure

Vaccination status

HBSIG

Hepatitis B vaccine

Follow-up

Notes

Not vaccinated

• Yes if >3 d after exposure

Yes

AS via GP

• No if <3 d

Yes

RDS via GP

Advise GP of timing

Vaccinated

• Yes if within 3 d

No

Repeat HBSIG

Consider trying newer at

nonresponder

1 mo vaccines at later stage

Course completed.

•No

Yes if primary

No

Levels <10 miU/mL

course <3 yr ago

Course completed

•No

Yes

GP to check results

If baseline antibodies

within 3 yr

of baseline blood test

>10 miU/mL advise RDS

Levels not checked"

or course completed

>73 yr, see Incomplete

Course

Incomplete course

• Yes if within 3 d

Yes

GP to check results

>10 miU/mL advise RS

(1 or 2 doses)

• No if <3 d.

Yes

of baseline blood test

<10 miU/mL advise RDS

GP, Family doctor; HBsAg, hepatitis B surface antigen; AS, accelerated schedule; RDS, rapid schedule; HBSIG, hepatitis B-specific immunoglobulin.

GP, Family doctor; HBsAg, hepatitis B surface antigen; AS, accelerated schedule; RDS, rapid schedule; HBSIG, hepatitis B-specific immunoglobulin.

Table 4

Management After Low-Risk Exposure Contact Is in Low-Risk Group or Known To Be HBsAg Negative and Has Had a Low-Risk Exposure

Table 4

Management After Low-Risk Exposure Contact Is in Low-Risk Group or Known To Be HBsAg Negative and Has Had a Low-Risk Exposure

Vaccination status

HBSIG

Vaccine

Follow-up

Notes

Not vaccinated

No

Yes

RS via GP

Vaccinated nonresponder

No

No

Consider using newer vaccines

Course completed

No

Yes if not checked

or <3 yr since first course

Incomplete course

No

Yes

GP to check results

>10 IU complete RS

of baseline test

GP, Family doctor; HBsAg, hepatitis B surface antigen; HBSIG, hepatitis B-specific immunoglobulin; RS, routine schedule; IU, international unit.

of baseline test

GP, Family doctor; HBsAg, hepatitis B surface antigen; HBSIG, hepatitis B-specific immunoglobulin; RS, routine schedule; IU, international unit.

Table 5 Prevalence of Hepatitis C

• General blood-doning population 0.06%

• Intravenous drug users 46-90%

"Statistics applies to all who received blood products before the mid-1980s.

that have a higher chance of carrying HCV. These United Kingdom figures are given in Table 5.

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