Hepatitis C infections resulting from medical treatment occur despite clear guidelines

May 23, 2018, American Osteopathic Association
Electron micrographs of hepatitis C virus purified from cell culture. Scale bar is 50 nanometers. Credit: Center for the Study of Hepatitis C, The Rockefeller University.

In a 10 year span, more than 130,000 patients were notified of medical errors that may have exposed them to blood-borne illness, including Hepatitis C. However, the majority of these notification events were discovered only after patients became acutely ill rather than through proactive reporting of violations of health safety protocols, according to a review in The Journal of the American Osteopathic Association.

Between 2001 and 2011, there were 35 reports of injection safety violations, affecting more than 130,000 patients across 17 states and Washington, DC. Patients who were exposed to Hepatitis C as part of these violations and never became acutely ill may be infected, unaware of it and spread the to others or be at risk for long term serious infection side effects, researchers say.

Hepatitis C is a contagious liver disease that is primarily spread through the blood of an infected person or, less commonly, through sexual contact. It can be an acute, short-term illness that occurs within six months of infection or a chronic illness that can last a lifetime existing virtually asymptomatic for years.

About 63 percent of HCV infections resulting from medical treatment were discovered only after patients experienced symptoms and were diagnosed, which led to notifying and screening other patients. Only 37 percent were identified after proactive reporting of injection safety violations.

"A major problem is that two out of three times, we're not learning about unsafe medical practices until it's too late," says Charles Defendorf, DO, an internal medicine resident trained at Rowan University School of Osteopathic Medicine and lead researcher on this review. "Once a patient is diagnosed with an infection, we can go back, alert, and screen anyone else connected to that facility. But by that time there has usually been opportunity for thousands more to have been infected."

Researchers found that patient notifications were often ineffective and with large numbers of people in need of screening often many informed are not tested for infection. In one case, 4,490 patients were notified of potential bloodborne pathogen exposure caused by reused syringes, but only 841 were screened for HCV. The thousands of patients who weren't screened could potentially be infecting others.

Dr. Defendorf says it's important that people know how to recognize the symptoms of HCV infection. While most people don't experience serious liver damage until after years of carrying the virus, many will suffer a brief bout of symptoms approximately four to six weeks after infection that can prompt treatment and avoidance of serious liver damage.

"Abdominal pain, nausea, vomiting, and jaundice are the primary symptoms," says Dr. Defendorf. "If these are experienced within four weeks after a procedure, it's a good idea to get tested." Physicians who find patients with elevated liver enzymes should have a conversation about potential infection, he added.

In addition to physician responsibility, patients are encouraged to advocate for themselves by observing their healthcare providers. The protocols for safe injection are comprehensively outlined in the Center for Disease Control's "One and Only" campaign. They include:

  • Never administer medications from the same syringe to more than one patient, even if the needle is changed
  • Do not enter a vial with a used syringe or needle
  • Medications packaged as single-use vials should never be used for more than one patient
  • Medications packaged as multi-use vials should be assigned to a single patient whenever possible
  • Bags or bottles of intravenous solution should not be used as a common source of supply for more than one patient
  • Absolute adherence to proper infection control practices be maintained during the preparation and administration of injected medications

"Hepatitis C transmission in medical settings is highly preventable and there are clear guidelines and standards to keep safe," says Dr. Defendorf. "All healthcare workers should know and abide by them."

Explore further: ACP and CDC issue recommendations for hepatitis B screening, vaccination, and care

More information: Charles M. Defendorf et al, Iatrogenic Hepatitis C Virus Transmission and Safe Injection Practices, The Journal of the American Osteopathic Association (2018). DOI: 10.7556/jaoa.2018.062

Related Stories

ACP and CDC issue recommendations for hepatitis B screening, vaccination, and care

November 20, 2017
Reducing chronic hepatitis B infections by screening at-risk adults, increasing hepatitis B vaccination rates, and linking infected persons to care is a public health priority, the American College of Physicians (ACP) and ...

Hepatitis E virus infections can be life threatening and transmitted through blood products

April 12, 2018
Hepatitis E virus (HEV) infection is once again in the spotlight, with two studies presented today at The International Liver Congress 2018 in Paris, France challenging the ideas that HEV infections are benign and self-limiting, ...

New hepatitis C treatments more effective, tolerable: FDA

May 11, 2017
(HealthDay)—Hepatitis C can be cured in about three months, allowing people with the viral disease to live longer, healthier lives, the U.S. Food and Drug Administration (FDA) says.

Urban ERs see high rates of hepatitis C infection

August 6, 2015
An urban emergency department that set up a hepatitis C testing protocol saw high rates of infection among intravenous drug users and Baby Boomers, with three-quarters of those testing positive unaware they were infected. ...

Risk of liver cancer from hepatitis B persists even after clearing the virus

April 22, 2016
Long-term infection with hepatitis B virus (HBV) can cause liver inflammation and increase the risk of liver cancer. Researchers from the US Centers for Disease Control and Prevention, however, found that resolving HBV infection ...

Many with hepatitis C missing out on treatment, study finds

January 11, 2015
(HealthDay)—Many hepatitis C patients get "lost" in the U.S. health care system, a new study suggests.

Recommended for you

Genetic flaw causes problems for many with hypothyroidism

October 23, 2018
With an estimated 120 million prescriptions filled each year, the thyroid medicine levothyroxine (marketed as Synthroid ) is one of the most popular prescription medicines in the United States. Most patients who suffer from ...

Collaboration yields possible treatment for rare neurodegenerative disorder

October 23, 2018
St. Jude Children's Research Hospital investigators have developed a new class of compounds that extended the lives and eased symptoms of mice with a progressive neurodegenerative human disorder. The findings appear today ...

'Game changer' tuberculosis drug cures 9 in 10

October 22, 2018
A new treatment for a drug-resistant strain of tuberculosis can cure more than 90 percent of sufferers, according to a trial hailed Monday as a "game changer" in the fight against the global killer.

AI doctor could boost chance of survival for sepsis patients

October 22, 2018
Scientists have created an artificial intelligence system that could help treat patients with sepsis.

Consuming caffeine from coffee reduces incident rosacea

October 22, 2018
(HealthDay)—Caffeine intake from coffee is inversely associated with the risk for incident rosacea, according to a study published online Oct. 17 in JAMA Dermatology.

Home-based biofeedback therapy is effective option for tough-to-treat constipation

October 22, 2018
Biofeedback therapy used at home is about 70 percent effective at helping patients learn how to coordinate and relax bowel muscles and relieve one of the most difficult-to-treat types of constipation, investigators report.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.