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July 12, 1993

Detection of Hepatitis C Virus Markers and Hepatitis C Virus Genomic—RNA After Needlestick Accidents

Author Affiliations

From the Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan (Drs Sodeyama, Kiyosawa, Urushihara, Matsumoto, Tanaka, and Furuta), and the First Department of Internal Medicine, Yamanashi Medical College, Tamaho-machi, Yamanashi-ken, Japan (Dr Akahane).

Arch Intern Med. 1993;153(13):1565-1572. doi:10.1001/archinte.1993.00410130081008

Background:  Needlestick accidents are a problem among health care workers. Using sensitive new assays, we evaluated the prevalence and features of hepatitis C virus (HCV) infection following a needlestick accident.

Method:  The clinical outcome and evolution of serum HCV markers were assessed in 90 hospital employees (recipients) who sustained needlestick injuries (selected from 146 episodes) involving 92 patients with clinical non-A, non-B hepatitis (donors).

Results:  Of the 92 patient donors, 62 (67%) and 88 (96%) were anti—C100-e and second-generation anti-HCV positive, respectively, at the time of the needlestick accident. During the follow-up period (≥ 6 months), acute non-A, non-B hepatitis developed in three of 90 recipients about 1 month after the accident. The three respective donors were positive for serum HCV-RNA at the time of the accident. Two of the three recipients became HCV-RNA positive just after the onset of hepatitis, and subsequently, HCV antibodies developed. None of the remaining 87 recipients had any clinical or laboratory evidence of hepatitis during follow-up, or experienced seroconversion for anti— C100-3 or second-generation anti-HCV. We measured additional HCV markers in 20 of the 89 donors; 16 had evidence of HCV infection (HCV-RNA). However, none of the respective recipients of any of these 20 became positive for HCV markers during follow-up.

Conclusion:  Although transmission of HCV infection by needlestick injury may be infrequent, such transmission does occur. Appropriate precautions should be taken to protect health care workers.(Arch Intern Med. 1993;153:1565-1572)