Survivability of Hepatitis C and HIV Viruses Once Exposed to Air

Once exposed to air, how long do both the Hepatitis C and HIV viruses remain “alive” and able to infect someone if say, left on a kitchen work surface, knife, etc?

Depends on temperature, humidity, and chemistry of surface and liquid in which virus is suspended (e.g., wood surface, metal surface, blood, soapy water, etc.)

You can probably find a few numbers if you search the medical literature http://www.ncbi.nlm.nih.gov/PubMed/ or government sites (e.g., http://www.cdc.gov or http://www.nih.gov) but another way of answering the questions you you seem to be getting at is to look at how people get infected with HIV and HCV. If anybody has ever been infected by a kitchen sink, it must be very rare compared. Both HIV and HCV are fragile and usually transmitted in fresh blood (syringes, transfusions, etc.) and occasionally in medical settings and rarely within households. When HBV is transferred within households, the transmission is usually attributed to shared toothbrushes or shared razors. I am unaware of reports of HCV transmission within households (other than sexual transmission).

So if someone with HIV or HCV bleeds on something, they should clean it up. But I wouldn’t fret about sharing a sink with someone who is infected with either HIV or HCV.

I believe this is partially incorrect. HCV (hepatitis C) is rarely transmitted sexually, whereas HBV (hepatitis B) is. HCV can be transmitted by shared razor blades or toothbrushes, too.

My question is: what if you borrowed a pair of tweezers from a first-aid kit from someone with HCV and, in removing a splinter from your finger, you prick yourself, causing it to bleed a bit? I don’t know how long the tweezers had been stored away, nor if they had been sterilized prior to use. (The owner is away, on business travel.)

How long would HCV live on the tweezers prior to being borrowed? (I washed my finger quite well immediately afterward.)

I didn’t mean to imply that hepatitis B transmission was not more often sexual than “household”, it is. What I meant was that “household” transmission (as opposed to sexual transmission) of hepatititis B is usually attributed to toothbrushes and razors and that therefore, in the absence of evidence of (nonsexual) household transmission of hepatitis C we can reasonably expect that if it does actually occur it would also be due to toothbrushes and razors.

Country Squire “HCV can be transmitted by shared razor blades or toothbrushes, too.”

Where do you get your information? If it is solid you should share it with the CDC which mentions such transmission as a theoretical risk not supported by any data. (That is not to say that it is contradicted by any data.)

As for your problem with the shared tweezers, I would think that the amount of blood would be tiny (if any) and that any virus would by now have had a good chance to dry up and lose its infectivity. It sounds like a very, very low risk exposure to me (but I’m not going to say zero).

If you look at the Morbidity and Mortality Weekly Report for October 16, 1998 / Vol. 47 / No. RR-19 “Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease” which is in the public domain and can be found at ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/rr4719.pdf
you will find information to help you sort out your risk. Note especially the bits about ear piercing and tatooing. Here are the relevant sections:

Transmission Modes
Most risk factors associated with transmission of HCV in the United States were identified in case-control studies conducted during 1978–1986 ( 40,41 ). These risk factors included blood transfusion, injecting-drug use, employment in patient care or clinical laboratory work, exposure to a sex partner or household member who has had a history of hepatitis, exposure to multiple sex partners, and low socioeconomic level. These studies reported no association with military service or exposures resulting from medical, surgical, or dental procedures, tattooing, acupuncture, ear piercing, or foreign travel. If transmission from such exposures does occur, the frequency might be too low to detect.

Percutaneous Exposures in Other Settings. In other countries, HCV infection has been associated with folk medicine practices, tattooing, body piercing, and commer-cial barbering ( 74–81 ). However, in the United States, case-control studies have reported no association between HCV infection and these types of exposures ( 40,41 ). In addition, of patients with acute hepatitis C who were identified in CDC’s sentinel counties viral hepatitis surveillance system during the past 15 years and who denied a history of injecting-drug use, only 1% reported a history of tattooing or ear piercing, and none reported a history of acupuncture ( 41; CDC, unpublished data ). Among injecting-drug users, frequency of tattooing and ear piercing also was uncommon (3%).
Although any percutaneous exposure has the potential for transferring infectious blood and potentially transmitting bloodborne pathogens (i.e., HBV, HCV, or HIV), no data exist in the United States indicating that persons with exposures to tattooing and body piercing alone are at increased risk for HCV infection. Further studies are needed to determine if these types of exposures and settings in which they occur (e.g., correctional institutions, unregulated commercial establishments), are risk factors for HCV infection in the United States.

Household Contact. Case-control studies also have reported an association between nonsexual household contact and acquiring hepatitis C ( 40,41 ). The presumed mechanism of transmission is direct or inapparent percutaneous or permu-cosal exposure to infectious blood or body fluids containing blood. In a recent investigation in the United States, an HCV-infected mother transmitted HCV to her hemophilic child during performance of home infusion therapy, presumably when she had an unintentional needle stick and subsequently used the contaminated needle in the child ( 88 ).
Although prevalence of HCV infection among nonsexual household contacts of persons with chronic HCV infection in the United States is unknown, HCV transmission to such contacts is probably uncommon. In studies from other countries of nonsexual household contacts of patients with chronic hepatitis C, average anti-HCV prevalence was 4% ( 15 ). Although infected contacts in these studies reported no other commonly recognized risk factors for hepatitis C, most of these studies were done in countries where exposures commonly experienced in the past from contami-nated equipment used in traditional and nontraditional medical procedures might have contributed to clustering of HCV infections in families ( 75,76,79 ).

Persons with No Recognized Source for Their Infection. Recent studies have dem-onstrated that injecting-drug use currently accounts for 60% of HCV transmission in the United States ( 2 ). Although the role of sexual activity in transmission of HCV remains unclear, £20% of persons with HCV infection report sexual exposures (i.e., exposure to an infected sexual partner or to multiple partners) in the absence of per-cutaneous risk factors ( 2 ). Other known exposures (occupational, hemodialysis, household, perinatal) together account for approximately 10% of infections. Thus, a potential risk factor can be identified for approximately 90% of persons with HCV in-fection. In the remaining 10%, no recognized source of infection can be identified, although most persons in this category are associated with low socioeconomic level.
Although low socioeconomic level has been associated with several infectious diseases and might be a surrogate for high-risk exposures, its nonspecific nature makes targeting prevention measures difficult.

[[Where do you get your information? If it is solid you should share it with the CDC which mentions such transmission as a theoretical risk not supported by any data. (That is not to say that it is contradicted by any data.)]]

Data on Hepatitis C have only recently been kept, and most databases (at least the one in our state) don’t have comprehensive risk information on cases like, say, HIV/AIDS surveillance programs do. I have seen one case of a wife of a hemophiliac who apparently sexually contracted Hep. C from her husband (who had acquired HIV and Hep. C from his medication). We also try to keep track of those who are dually diagnosed with HIV and Hep C, and thirty percent of those we know about report being men who have sex with men but NOT injection drug users. I suspect that many of them acquired it sexually.

“Data on Hepatitis C have only recently been kept…”

That’s a little misleading. If you read the 1998 CDC report excerpted below (“Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease” you will note that: “Most risk factors associated with transmission of HCV in the United States were identified in case-control studies conducted during 1978–1986.” Note the dates. It’s true they didn’t call it hepatitis C then, it was non-A non-B hepatitis (NANB), but in the U.S., most NANB infectious hepatitis has been shown to be caused by HCV.

Brady, “Emergency Care”, 9th edition.

(my bold added)

HIV can’t survive more than 10 minutes outside the body, even in blood spatters of significant volume it doesn’t do well once the temperature starts to lower, and the virus is outside the host body. Jill, that’s what I’ve been told by Instructors in my class but I can’t find any cite to back that up. Is that an accurate statement? Surely I can say that next to HBV, HIV is an incredibly delicate and short-lived virus outside the human/simian body. It’s a filovirus and is a delicately structured organism, unlike HBV which is a hardy little bastard.

My rule? Bleach bleach bleach. Nitrile, double gloved. Mask. More bleach.

Cartooniverse

What I meant was that Hepatitis C only became a reportable disease in recent years in most states. In my state, comprehensive risk information is not collected in the Hep. C database because we don’t have the staffing to hunt it down like we do for HIV/AIDS. The virus itself was just identified a few years ago. We do know it is primarily transmitted via injection drug use and - previously - from blood transfusions, but a sizeable proportion of cases is still in the “community acquired” (we dunno how they got it) pot.

“What I meant was that Hepatitis C only became a reportable disease in recent years in most states. In my state, comprehensive risk information is not collected in the Hep. C database because we don’t have the staffing to hunt it down like we do for HIV/AIDS.”

Information on risk factors for becoming infected with hepatitis does not depend on routine disease reporting. For most diseases (and certainly for hepatitis A, B, and C) the reporting is incomplete and the collection of risk information is spotty. This isn’t just in JillGat’s state. That is why other sources are used such as the case-control studies referred to in the CDC recommendations. Another important source is the data collected by the sentinel counties. These are 5 or 6 counties in which federally supported public health workers try to identify and collect risk information on all cases of infectious hepatitis. The risk factor information gathered from these sentinel counties is then extrapolated to the whole country.

As you might expect, I’ve done a heck of a lot of Internet searching since this incident. I saw a couple of site that say it can be contracted that way–and that persons who live in households with HCV people should learn safe shared-living practices.

I will be very, very relieved if you are correct. (The account I relayed is true, BTW.)

“Hepatitis B Virus kills up to 200 Health Care workers a year in the United States, more than any other occupationally acquired disease.”

Let’s hope this statement is way out of date since a safe and effective vaccine has been available to protect against hepatitis B there for more than 15 years. No one should be involved in direct patient care who has not been vaccinated and responded to the vaccine.

Helpful info from the CDC.

http://www.cdc.gov/hepatitis/c/cfaq.htm