Bloodborne pathogens are those organisms that are carried in the blood and are capable of causing disease. Common bloodborne pathogens that cause disease in humans include human immunodeficiency virus (HIV), Hepatitis B (HBV), and Hepatitis C (HCV). These viruses are usually transmitted through exposure to blood, but you may also be exposed through other body fluids.
HIV/AIDS
Human immunodeficiency virus is one of the common bloodborne pathogens. Also called HIV, this is the virusthat causesacquired immune deficiency syndrome (AIDS). Since the virus was first identified in the United States in the early 1980’s, two types of HIV viruses have been identified. They are called HIV-1 and HIV-2. HIV-1 is the type most people talk about when they use the term HIV. Both types of HIV destroy T cells in the body. These T cells are critical in helping your body fight disease; when these T cells are destroyed, your body becomes ‘immunocompromised’ or more susceptible to other diseases.
Transmission of HIV
There are a number of different ways that HIV can be transmitted from one person to another:
- Unprotected sex with someone who has HIV will increase the risk of HIV transmission. This is particularly true if there is any contact with blood during the sexual act.
- Intravenous drug users who share needles, syringes, or other equipment used to prepare drugs are at increased risk for HIV transmission.
- Health care workers who care for an HIV patient may be at risk if they are stuck or cut with a contaminated needle, lancet or other sharp object. Although the risk is low, any worker who receives such an injury should follow the policy at their place of employment.
- Infants born to HIV infected mothers are at risk since the virus can be passed from mother to child particularly during the birth process.
- The blood supply and tissues for donation in the United States undergo many tests to ensure that they do not harbor the HIV virus; therefore, the risk of receiving contaminated blood in the U.S. is very slim. However, there is a very remote risk of infection through blood transfusions and tissue donations.
- HIV can be transmitted through medical or dental practices. The CDC and OSHA have very strict standards in place that have been established to minimize this risk. If your doctor and dentist practice these safety standards, the risk of HIV transmission in the private office is very remote.
- Tattooing or body piercing may present a potential risk of HIV transmission; however, if equipment is properly sterilized, this risk is almost non-existent. In fact, there have been no documented cases of HIV transmission from tattooing or body piercing.
The HIV organism cannot live outside the human body. It cannotbe spread by insects, saliva, tears, casual contact, sharing dishes or utensils, or breathing air around an HIV infected person.
Symptoms of HIV Infection
When a person is first infected with HIV, there may be no symptoms. Some people may have vague symptoms that mimic the flu – fever, malaise, and headache. People with HIV may appear to be healthy for months or years after infection. However, it is important that anyone who is at risk should be tested for the virus. If the test is positive, the infected person should see a doctor who specializes in treatment of HIV patients. Many treatments can be used to delay the onset of symptoms and keep an HIV patient feeling healthy for many years. The medications available today can slow the damage to the immune system. If HIV is left untreated, the infected person is at high risk for developing kidney failure, eye disorders, heart disease, and certain forms of cancer.
Despite the fact that the current medications used for HIV are effective in improving the health of the infected person, treatment must continue for the person’s lifetime. A doctor who specializes in HIV treatment to prevent or delay the development of AIDS must monitor the HIV positive person.
AIDS is the stage of HIV infection when the individual’s immune system can no longer fight disease. Extensive research into HIV and AIDS has led to the development of combinations of medications that allow many people with HIV to live decades before developing AIDS. However, there is currently no cure for HIV and AIDS.
HIV Prevention
HIV is primarily transmitted through unprotected sex or sharing intravenous drug devices. Therefore, HIV prevention should start with steps to eliminate those risky behaviors. First, you should know your HIV status through testing. If you are in a high-risk group, you should be tested on a regular schedule as established by your doctor. Be sure you know the HIV status of your sexual partners.
Limit your number of sexual partners and use latex condoms with all partners. Latex condoms are very effective at preventing infection with HIV and other sexually transmitted diseases. Natural condoms do NOT provide the same level of protection so be sure the condoms are latex.
If you are an IV drug user, get treatment to help you stop drug use. Many health departments have programs that can help you stop IV drug abuse. If you continue to inject drugs, always use clean needles and do not share any of the drug use equipment with anyone else. If you think you have been exposed to HIV, get medical treatment from a clinic or private physician in your area. Early treatment may prevent infection.
Hepatitis B
Hepatitis B is a bloodborne liver disease that results from infection with the Hepatitis B virus (HBV). Although it is usually spread through blood, other body fluids from a person infected with the Hepatitis B virus can also cause the disease. Hepatitis B virus infection is called “acute” when it occurs within 6 months after a person is exposed to the HBV. This short-term infection can lead to a long-term, chronic Hepatitis B infection if the disease is not treated and the virus remains in your body. Although Hepatitis B can lead to death, the good news is that there is a vaccination to prevent the disease.
Transmission of HBV
As a bloodborne pathogen, HBV is found mainly in blood, but may also be found in other body fluids. The mode of transmission for HBV is very similar to the way HIV is transmitted including:
- Unprotected sex with someone who is infected may increase the risk of HBV transmission.
- Intravenous drug users who share needles, syringes, or other equipment used to prepare drugs are at increased risk for HBV transmission.
- Health care workers may be at risk if they are stuck or cut with a contaminated needle, lancet or other sharp object.
- Infants born to infected mothers are at risk since the virus can be passed from mother to child particularly during the birth process.
- HBV can be transmitted through medical or dental practices if the doctor or dentist does not practice the safety standards recommended by the CDC and OSHA.
- Tattooing or body piercing may present a potential risk of HBV transmission; however, if equipment is properly sterilized, this risk is almost non-existent.
- Sharing personal care items such as razors, toothbrushes or other items that might harbor HBV may present a risk for infection.
As with HIV, HBV cannot be spread by insects, saliva, tears, casual contact, sharing dishes or utensils, or breathing air around an HBV infected person.
Symptoms of HBV
Once exposed to and infected by the Hepatitis B virus, symptoms will appear in six weeks to six months. Symptoms may vary by age. For example, most children under the age of 5 years may be asymptomatic with infection; as many as half of the adults over the age of 25 years will have early symptoms. Development of the chronic form of HBV infection seems to be related to the age at initial infection — the younger the age at infection, the higher the risk for developing the chronic infection. People with chronic HBV infection may have no symptoms or may have very severe symptoms. Symptoms of HBV infection may include:
- Fever
- Fatigue and general malaise
- Loss of appetite
- Nausea and vomiting
- Abdominal pain
- Dark urine
- Jaundice (yellowing of the skin and whites of the eyes)
- Liver failure (1% of cases)
- Liver cancer (typically with chronic disease)
Prevention of HBV
Transmission of HBV can be reduced or prevented by:
- Screening of pregnant women and treatment of infants born to HBV infected mothers.
- Vaccination of all children through the age of 18 years
- Vaccination of adults who may be at increased risk for infection (healthcare workers, people with multiple sexual partners, IV drug users)
Fortunately, vaccination rates are high among infants and children. However, vaccination rates are still low in high-risk adults. Most HBV infections continue to occur in these groups.
Hepatitis C
The most common bloodborne pathogen infection in the U.S. is Hepatitis C virus (HCV). Among all of the bloodborne diseases, HCV is the one that is least likely to be transmitted through sexual contacts; however, it CAN be transmitted sexually.
Transmission of HCV
As with the other Hepatitis infections, HCV is most often transmitted through repeated exposure to infected blood. Because of this mode of transmission, the same groups are at risk for HCV infection.
- Blood transfusions with infected blood used to be the most common method of transmission. Since screening of all blood products is so rigorous, this mode of transmission is almost unheard of in the United States.
- Intravenous drug users who share needles, syringes, or other equipment used to prepare drugs are at increased risk for HCV transmission.
- Health care workers may be at risk if they are stuck or cut with a contaminated needle, lancet or other sharp object.
- Infants born to infected mothers are at risk since the virus can be passed from mother to child particularly during the birth process.
- Unprotected sex and sharing razors and toothbrushes with an infected person CAN transmit HCV, but these modes of transmission are much more uncommon.
Symptoms of HCV
The majority of people infected with HCV usually have only mild clinical symptoms. A large majority of HCV infections results in chronic disease and many of these people will have liver disease. People with HCV infections may be at risk for chronic liver disease for the rest of their lives.
Most people with new HCV infection do not have symptoms. If symptoms do occur, they may be identical to symptoms of HBV infection including:
- Fever
- Fatigue and general malaise
- Loss of appetite
- Nausea and vomiting
- Abdominal pain
- Dark urine
- Jaundice (yellowing of the skin and whites of the eyes)
- Liver failure
- Liver cancer