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Original Investigation
April 8, 2002

Risk of Hepatitis C Virus Transmission From an Infected Gynecologist to Patients: Results of a 7-Year Retrospective Investigation

Author Affiliations

From the Institute of Virology, National Reference Centre for Hepatitis C, University of Essen, Essen, Germany (Drs Ross, Viazov, and Roggendorf); Itzehoe Public Health Administration, Itzehoe, Germany (Dr Thormählen); Itzehoe Academic Teaching Hospital, Itzehoe (Drs Bartz and Deister and Mrs Tamm); and Institute of Medical Microbiology and Virology, University of Kiel, Kiel, Germany (Dr Rautenberg).

Arch Intern Med. 2002;162(7):805-810. doi:10.1001/archinte.162.7.805
Abstract

Background  Currently, it is not known how often hepatitis C virus (HCV) is transmitted from infected health care workers to patients during medical care. In the present investigation, we tried to determine the rate of provider-to-patient transmission of HCV among former patients of an HCV-positive gynecologist after it was proven that he infected one of his patients with HCV during a cesarean section.

Methods  All 2907 women who had been operated on by the HCV-positive gynecologist between July 1993 and March 2000 were notified about potential exposure and were offered free counseling and testing. The crucial differentiation between HCV transmissions caused by the gynecologist and infections contracted from other sources was achieved by epidemiological investigations, nucleotide sequencing, and phylogenetic analysis.

Results  Of the 2907 women affected, 78.6% could be screened for markers of HCV infection. Seven of these former patients were found to have HCV. Phylogenetic analysis of HCV sequences from the gynecologist and the women did not indicate that the virus strains were linked. Therefore, no further iatrogenic HCV infections caused by the gynecologist could be detected. The resulting overall HCV transmission rate was 0.04% (1 per 2286; 95% confidence interval, 0.008%-0.25%).

Conclusion  To our knowledge, this is the largest retrospective investigation of the risk of provider-to-patient transmission of HCV conducted so far. Our findings support the notion that such transmissions are relatively rare events and might provide a basis for future recommendations on the management of HCV-infected health care workers.

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