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Preventing the spread of hepatitis B and C viruses: where are germicides relevant?
S A Sattar1, J Tetro, V S Springthorpe
1Centre for Research on Environmental Microbiology, Faculty of Medicine, University of Ottawa, Ontario, Canada.
Insights
Hepatitis B (HBV) and Hepatitis C (HCV) are bloodborne viruses. While direct contact is the main transmission route, disinfectants and surrogates aid in prevention and research.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are leading causes of chronic liver disease, cirrhosis, and liver cancer.
- Current chemotherapy options are limited, and only HBV is preventable by vaccination.
- Both viruses are enveloped and susceptible to inactivation, challenging environmental survival myths.
Purpose of the Study:
- To review the transmission routes and inactivation methods for HBV and HCV.
- To evaluate the role of disinfectants and potential surrogates in preventing viral spread.
- To address challenges in HBV and HCV laboratory research.
Main Methods:
- Review of existing literature on HBV and HCV transmission and inactivation.
- Analysis of the efficacy of germicidal chemicals and microbicides.
- Assessment of animal virus surrogates for laboratory studies.
Main Results:
- Primary transmission occurs through direct parenteral/percutaneous exposure to infected body fluids.
- Germicidal chemicals are crucial for disinfecting shared devices, sharps, and medical equipment, and for cleaning spills.
- General environmental disinfection has a limited role; low-level disinfectant claims against HBV/HCV should be discouraged.
- Animal surrogates like duck HBV and BVDV show promise for research.
Conclusions:
- Preventing direct contact with contaminated materials is key.
- Targeted disinfection and potential microbicides are important for transmission control.
- Animal surrogates offer a viable path forward for HBV and HCV research.
Abstract:
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most prevalent bloodborne pathogens. Infections caused by these organisms can become chronic and may lead to liver cirrhosis and carcinoma. Limited chemotherapy is now available, but only HBV can be prevented through vaccination. Both viruses are enveloped and relatively sensitive to many physical and chemical agents; their ability to survive in the environment may not be as high as often believed. As a result, their spread occurs mainly through direct parenteral or percutaneous exposure to tainted body fluids and tissues. Careful screening of and avoiding contact with such materials remain the most effective means of protection. Nevertheless, the indirect spread of these viruses, although much less common, can occur when objects that are freshly contaminated with tainted blood enter the body or contact damaged skin. Germicidal chemicals are important in the prevention of HBV and HCV spread through shared injection devices, sharps used in personal services (such as tattooing and body piercing), and heat-sensitive medical/dental devices (such as flexible endoscopes) and in the cleanup of blood spills. Microbicides in vaginal gels may also interrupt their transmission. General-purpose environmental disinfection is unlikely to play a significant role in the prevention of the transmission of these viruses. Testing of low-level disinfectants and label claims for such products against HBV and HCV should be discouraged. Both viruses remain difficult to work with in the laboratory, but closely related animal viruses (such as the duck HBV) and the bovine viral diarrhea virus show considerable promise as surrogates for HBV and HCV, respectively. Although progress in the culturing of HBV and HCV is still underway, critical issues on virus survival and inactivation should be addressed with the use of these surrogates.