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HEPATITIS C FROM NEEDLESTICK INJURIES.

Hepatitis C virus (HCV) has joined hepatitis B virus and HIV as an identifiable agent that can be transmitted from a needlestick. This Japanese study followed 90 health- care workers for at least 6 months after needlestick accidents involving a source patient with non-A, non-B hepatitis. Because the injuries occurred between 1979 and 1990, the analysis was based on frozen serum samples.

At the time of the accident, 96 percent of the source patients had a positive second-generation antibody test for HCV, and 80 percent of 20 randomly-selected source patients were positive for HCV-RNA.

Acute hepatitis developed in 3 of 90 workers; in each case, the source patient was HCV-RNA-positive. Two of the three workers became positive for HCV-RNA and had chronic hepatitis at last follow-up (1 and 7 years, respectively). The third worker had briefly elevated transaminase levels, but remained asymptomatic and was consistently negative for all HCV markers. The other 87 workers remained free of any sign of hepatitis.

Comment: Although this study was small and retrospective, it suggests that the rate of HCV transmission from a needlestick could be as high as several percent. Larger prospective studies are needed to confirm these results.

— ASB

Published in Journal Watch General Medicine July 23, 1993

Citation(s):

Sodeyama T et al. Detection of hepatitis C virus markers and hepatitis C virus genomic-RNA after needlestick accidents. Arch Intern Med 1993 Jul 12 153 1565-1572.

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