[Risk of transmission of hepatitis C virus by digestive endoscopy].
OBJECTIVE
In 30 to 50% of cases, the route of transmission of virus C remains unknown. The aim of this study was to investigate the effectiveness of manual cleaning and disinfection procedures after endoscopic examinations in highly infected patients.


METHODS
In 39 patients with chronic hepatitis C and a high level of replication, a gastroscopy with biopsy was performed with a fully submersible endoscope. Cleaning and disinfection were carried out with the following protocol: cleaning with detergent solution (Sekulyse), rinsing, 3 to 5 min immersion into a glutaraldehyde disinfectant solution (Sekucid) and final rinsing. One hundred mL of sterile water was flushed through the biopsy channel immediately after removal of the endoscope (T1), after cleaning (T2), and after final disinfection (T3). These 100 mL were collected in aliquots for viral and bacterial screening. Virus C particles were searched for in the effluent of the biopsy channel using two methods of polymerase chain reaction.


RESULTS
Virus C particles were found in 2 of 39 patients in T1 aliquots collected before washing. Routine cleaning with a detergent eliminated all viral particles, as tests were negative at T2 and T3. The usual bacteria (Pseudomonas, Streptococcus, Neisseria...) were detected at T1 and had disappeared after total disinfection at T3.


CONCLUSIONS
Virus C hepatitis could be transmitted during endoscopic examination, but cleaning and disinfection procedures effectively eliminated all viral particles.
Rey
J F
JF
Département d'Hépatologie et de Gastroentérologie, Institut Arnault-Tzanck, Saint-Laurent-du-Var.
Halfon
P
P
Feryn
J M
JM
Khiri
H
H
Masseyeff
M F
MF
Ouzan
D
D
D004203:Disinfection / Q000379:methods; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000209:etiology* / Q000235:genetics / Q000635:transmission; D006801:Humans; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors
D012367:RNA, Viral
Risque de transmission du virus de l'hépatite C par l'endoscopie digestive.