Author Affiliations: Johns Hopkins School of Medicine, Baltimore, Md.
Grand Rounds at The Johns Hopkins Hospital Section
Editors: David B. Hellmann, MD, D. William Schlott, MD, Stephen D.
Sisson, MD, The Johns Hopkins Hospital, Baltimore, Md; David S. Cooper, MD,
Contributing Editor, JAMA.
Hepatitis C virus (HCV) transmission following a needlestick is an important
threat to health care workers. We present the case of a 29-year-old medical
intern who sustained a needlestick injury from a source patient known to be
infected with both human immunodeficiency virus and HCV. The case patient
subsequently developed acute HCV infection. The optimal strategy for diagnosing
HCV infection after occupational exposures has not been defined. At a minimum,
HCV antibody and alanine aminotransferase testing should be done within several
days of exposure (to assess if the health care worker is already infected
with HCV) and 6 months after percutaneous, mucosal, or nonintact skin exposure
to blood or infectious body fluids from an HCV-infected patient. Currently,
it is not possible to prevent HCV infection after exposure. However, recent
data suggest that early treatment of acute HCV infection with interferon α
may be highly effective in preventing chronic HCV infection. These data underscore
the importance of identifying persons with acute HCV infection and promptly
referring them to experienced clinicians who can provide updated counseling
Sulkowski MS, Ray SC, Thomas DL. Needlestick Transmission of Hepatitis C. JAMA. 2002;287(18):2406–2413. doi:10.1001/jama.287.18.2406