Transmissions of hepatitis C virus during the ancillary procedures for assisted conception: Case report

Abstract

Since mother to child transmissions of hepatitis C virus (HCV) have been reported to be low, teams involved in assisted reproductive technologies have accepted HCV positive patients into their programmes. We report in the present paper two cases of undoubted patient to patient HCV transmission while patients were attending for assisted conception. In both cases, HCV genotyping and sequencing of the first hypervariable region of the HCV genome provided molecular evidence for nosocomial transmission. Investigations made to elucidate the route of contamination have shown that the most likely route of contamination is through healthcare workers. Such nosocomial HCV infection has been reported in other healthcare situations, mainly in dialysis units, and physical proximity was also suspected to be at the origin of the infection. We conclude that assisted reproduction teams must be very prudent when including such patients in their programmes.

Reproductive Performance of Couples Discordant for Hepatitis B and C Following IVF Treatment

“…Despite the demonstration of low risk of cross contamination and of nosocomial transmission during IVF or ICSI techniques from HCV+ couples (17,19), the possibility for transmission merits special precautions in handing potentially infective material in the laboratory. This includes handling the samples separately in the laboratory from other HCV-couples, and using separate incubators for embryo culture.…”

“…Moreover, the value of routine detection of HCV viral RNA in seminal fluid and culture medium is questionable (17), and the results must be interpreted with caution, as seminal amplification inhibitors may render the results of PCR unreliable (11,18). Notwithstanding the possibility of sexual transmission, a recent report has drawn attention to the possibility of nosocomial transmission of HCV during ancillary procedures for ART (19), indicating the need for exercising special precaution in specimen handing in the embryology laboratory.…”

Viral Hepatitis and Assisted Reproduction

“…Transmission of HBV and HCV is the main areas of research, and limited information is now available on HDV and HGV. Concerns over laboratory/nosocomial infection in assisted reproduction clinics have been of great concern since the publication of a case report that described the transmission of HCV from an infected patient undergoing IVF to two non-infected patients undergoing IVF within the same clinic during the same time period [4][5][6]. These cases led to the development of additional regulations for ART in hepatitis patients in 2001 and the emergence of ''viral risk'' laboratories in France where serodiscordant couples (HCVpositive men and HCV-negative women) undergo ART.…”

Reply to Bénet et al

“…11 Another observation reported hepatitis C virus transmission to patients in the in vivo fecundation process, likely through healthcare workers during routine procedures such as daily US. 12 For more common viruses such as human papillomavirus related to an increased risk of cervical cancer, quantitative studies may be valuable. Lastly, we agreed with the conclusions of Bénet et al 1 that appropriate investigations are warranted in order to guarantee patients' safety regarding these semicritical devices.…”