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Common Bloodborne Pathogens

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Common Bloodborne Pathogens

Although many pathogens can be present in the blood, the three most common viruses that can cause serious illness are:

  • Human immunodeficiency virus (HIV)
  • Hepatitis B virus (HBV)
  • Hepatitis C virus (HCV)

Key Takeaway

UNIVERSAL PRECAUTIONS dictate that the first responder assumes that all patients may harbor infectious organisms such as HIV and hepatitis viruses and takes steps to prevent transmission.

Human Immunodeficiency Virus

HIV is a virus that can affect the body’s immune system, which is responsible for fighting infections. People with untreated HIV infection become sick and easily infected by common pathogens that a healthy immune system would have eradicated easily. With today’s medical innovations, people with HIV can take medications to control the virus, strengthen their immune systems, and stay healthy for many years. 

As HIV progresses, a time will come when the person with the disease will have a significantly weakened immune system. At this stage, acquired immunodeficiency syndrome (AIDS) is likely to be the diagnosis.

HIV can affect person’s immune system.

HIV can affect a person’s immune system.


Related Video: What is Human Immunodeficiency Virus (HIV)?


Signs and Symptoms of HIV Infection

Patients with recent HIV infection generally do not experience any symptoms, but when they do, they will initially experience:

  • Fever
  • Sore throat
  • Headaches
  • Muscle pain and joint pains 

These symptoms can last for up to 2 weeks. These symptoms are very often mild, and most patients will attribute them to a flu-like illness or not even recall having them. 

In the first few years after the initial HIV infection, most people will continue to have a very mild form of the illness. Other signs and symptoms during this period include:

  • Decreased appetite
  • Significant fatigue
  • Enlarged lymph nodes
  • Abdominal pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Weight loss

Patients will also have a greater tendency to get lung infections, brain infections, eye infections, and yeast infections in the mouth. These infections will occur more frequently as the individual’s immunity cells become significantly fewer and less able to protect the individual from other infectious organisms.

Treatment for HIV

Key Takeaway

  • HIV destroys normal immunity cells.
  • The HIV viral load is seen in highest concentration in the blood, but it is also found in urine, saliva, secretions (vaginal, semen), and sweat.
  • Recently infected patients do not have pronounced signs or symptoms. Generalized flu-like symptoms are the most common.
  • Mothers can transmit HIV during pregnancy, childbirth, or breastfeeding.
  • Treatment for HIV only reduces the viral load, and the patient must be treated throughout their lifetime.

There are different types of medications that doctors use to control HIV infection. Patients must work closely with their doctor to ensure they are on the most current HIV medications. Since there are also HIV-related infections and conditions, doctors may prescribe additional therapies to treat them.

Antiretroviral medication keep HIV viral levels undetectable.

Antiretroviral medications help keep HIV viral levels undetectable.

Hepatitis B Virus (HBV) Infection

Hepatitis refers to an inflamed liver or liver injury. Hepatitis B is a viral pathogen that infects a person and causes a specific type of hepatitis. Fortunately, there are vaccinations to protect against HBV infections and advanced medications to treat them. Many healthcare workers are required to be vaccinated when in positions that carry a higher risk for exposure.

Close personal contact can be an avenue for HBV transmission. If infected blood or other bodily fluids get into tiny cracks or breaks in the skin, mouth, or eyes (like HIV infection), HBV can be transmitted. The HBV is a resilient virus that can remain infectious up to a week outside the body. 

In the healthcare setting, an accidental needlestick can spread HBV to patients and healthcare providers. Healthcare professionals receive training and utilize specialized protective equipment to prevent exposure.

Signs and Symptoms of Hepatitis B Infection

The symptoms of a hepatitis B infection can vary from person to person. Infected individuals can develop:

  • Fever
  • Abdominal pain
  • Fatigue
  • Decreased appetite
  • Nausea
  • Jaundice – yellowing of the white part of the eyes and the skin

Definitive findings indicating a severe infection and liver damage include:

  • Jaundice – that persists over time 
  • Ascites – swelling of the abdomen due to fluid accumulation
  • Confusion – in the late stages

Many patients, especially infants and children, do not have symptoms. However, this does not mean that the infection is under control. If an individual’s immune system does not eradicate the virus, the individual may develop chronic hepatitis B, and the symptoms may not be apparent until the liver disease reaches a later stage. 

The most common early sign of chronic hepatitis B is fatigue. Common complications of HBV infection affect the liver, leading to problems such as cirrhosis (fibrosis or scarring of the liver) and liver cancer.

Hepatitis B transmitted via body fluids.

Hepatitis B can be transmitted via body fluids such as blood and semen.

Treatment for Hepatitis B Infection

Treatment may not be necessary for most healthy adult patients with hepatitis B. These patients have a robust immune system to combat the disease.

However, a patient whose infection becomes chronic requires long-term antiviral medications. Frequent blood tests are necessary to evaluate the effectiveness of the antiviral treatment regimen. 

If a patient’s condition progresses and advanced liver cirrhosis develops, the definitive treatment is a liver transplant.

Chronic hepatitis B can lead to liver cirrhosis and transplant.

Chronic hepatitis B infection can lead to liver cirrhosis and the need for a transplant.

Key Takeaway

  • Hepatitis B virus is commonly transmitted via sexual intercourse. It can also be transmitted through needles and contact with other body fluids.
  • Hepatitis B cannot be spread by hugging or kissing, sharing utensils or cups, sneezing, coughing, or breastfeeding.
  • The virus can survive outside the body for quite some time in certain conditions.
  • Patients with a positive HB antigen test have been infected with hepatitis B virus.
  • Patients positive for anti-HBs or HBsAB (antibody) have recovered from a previous hepatitis B infection.
  • Most people recover from acute infection from hepatitis B virus within 6 months without treatment.
  • If the infection remains over time and becomes chronic, patients may develop liver cirrhosis and liver cancer.
  • In chronic infections, symptoms will manifest if the infection is severe and as it progresses into its later stages.
  • Infected mothers who are pregnant must take antiviral medications to prevent the spread of infection to their unborn child.
  • HBV infection can be prevented by vaccination.

Hepatitis C Virus (HCV) Infection

HCV has the same infectivity and causes similar disease symptoms to HBV infection. It also causes inflammation of the liver, known as hepatitis, which can potentially cause long-term damage to liver tissue. 

Patients infected with hepatitis C may also be asymptomatic or only have mild symptoms at the outset and for some time—even years. These patients may not even know that they are infected with HCV. Chronic infection with hepatitis C will eventually cause damage to the liver.

Hepatitis C virus testing.

Hepatitis C Virus Testing

Symptoms of Hepatitis C Infection

Patients with hepatitis C are commonly asymptomatic or complain of nonspecific symptoms, making it difficult to ascribe them to the hepatitis C infection. As with HBV, the most common complaint is fatigue. Patients may also complain of loss of appetite, muscle and joint pain, nausea, weakness, and weight loss.

Complications of Hepatitis C

When left untreated, more than half of patients with hepatitis C develop a chronic infection, which may cause considerable damage to the liver over time. In some cases, this may lead to cirrhosis or liver cancer. It is one of the more common causes of liver transplant in the United States. The early detection and treatment of hepatitis C are essential to prevent this from happening.

Hepatitis C causes liver inflammation and possibly serious damage.

Hepatitis C causes liver inflammation and possibly serious damage.

Key Takeaway

  • Patients at risk for hepatitis C infection are people who received blood transfusions or organ transplants before 1992, and those who are current or prior intravenous drug users.
  • Patients infected with hepatitis C infection may only complain of fatigue.
  • Infected pregnant mothers can transmit the hepatitis C virus to their unborn child.
  • The virus cannot be spread through kissing, hugging, sneezing, coughing, nor sharing food water, utensils, and drinking glasses.
  • Liver cirrhosis and liver cancer are chronic complications of hepatitis C infection.
  • 60-80% of infected patients develop chronic hepatitis C infection.
  • A negative anti-HCV test means that there is no hepatitis C infection.
  • There is no vaccine to prevent hepatitis C virus infection.