Hepatitis C Virus Infection in Medical Personnel After Needlestick Accident

Abstract

Hepatitis C virus infections in medical personnel after needlestick accidents have been documented generally by detection of seroconversion to a hepatitis C virus nonstructural region antigen, c100-3 (a marker of infection). We tested for hepatitis C virus core-derived antibodies and genomic RNA in addition to c100-3 antibody in 159 cases of needlestick exposure that did not involve patients positive for HBsAg. Of these we found 68 cases with index patients positive for both hepatitis C virus RNA and antibodies and members negative for antibodies to HCV core or c100-3 before the needlestick accidents. Seven of these medical personnel became infected with hepatitis C virus after the accidents. Their hepatitis was generally subclinical or self-limited and transient, except for one patient in whom liver enzyme elevation persisted along with the antibodies. In our study, the risk of hepatitis C virus transmission from a single needlestick accident with hepatitis C virus RNA-positive blood was 10%, considerably higher than the 4% estimated in a previous study. We found that donor blood with antibody to an hepatitis C virus core-derived peptide with enzyme-linked immunosorbent assay optical densities greater than 2.0 carried a significant risk of transmitting hepatitis C virus to needlestick victims. No hepatitis C virus seroconversions occurred in medical personnel exposed to hepatitis C virus antibody-negative or hepatitis C virus RNA-negative blood; however, one such exposure resulted in a very mild non-A, non-B, non-C hepatitis.

Risk of infection from needle reuse at a phlebotomy center

“…Between January 1998 and March 1999, 900 butterfly needles are known to have been ordered at the site. The probability of HIV, [8][9][10][11][12][13][14] HBV, [15][16][17] and HCV [18][19][20][21][22] infection following needlestick injury with contaminated blood was used as an estimate of the unknown transmission probability from needle reuse 4,5 (Table 1). We calculated a lower-bound estimate for the prevalence of each infection in the largely suburban clinic population by using National Health and Nutrition Examination Survey III (NHANES III) estimates [23][24][25] (Table 1).…”

HETA 99-0265-2830, Venus & Mars, Orlando, Florida, and HETA 2000-0013-2830, Body Piercing by Bink, Tallahassee, Florida.

“…The risk factors for HCV transmission in the occupational setting are not well-defined. 11,12,13,14 During the past decade, the annual number of newly acquired HCV infections has ranged from an estimated 28,000 to 180,000. 15 Of these, an estimated 2-4 % occurred among healthcare personnel who were occupationally exposed to blood.…”

Risk of blood splashes in otorhinolaryngology surgery: do we really require protection?

“…[1][2][3][4] Such infection may either transmit through percutaneous injuries or mucocutaneous exposure of blood or body fluids. [5][6][7][8][9] Studies showed that the percutaneous injury has the highest risk of transmitting infective pathogens, however there is also chance of transmission of infection via contact with skin or mucous membranes. [10][11][12] The incidence of HIV transmission through accidental exposure is 0.5% for needle stick injury with percutaneous hollow-bore needles and 0.1% for exposure to mucous membrane.…”