title: Investigation of potential iatrogenic transmission of hepatitis C in Victoria, Australia.
abstract: OBJECTIVE
  To determine the level of exposure to medical and surgical procedures among Australian-born patients whose mode of acquisition of the hepatitis C virus (HCV) is unknown.
  
  
  METHODS
  Place and time of study: Melbourne, Australia, 1998-2000.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Structured questionnaire administered by one interviewer.
  
  
  METHODS
  Referral centre for hepatitis C in a tertiary teaching hospital.
  
  
  METHODS
  Australian-born individuals persistently HCV antibody (anti-HCV) positive on at least two second-generation commercial assays.
  
  
  METHODS
  Demographic and self-reported exposure data.
  
  
  RESULTS
  Of 135 anti-HCV positive individuals with no known mode of transmission, 54 (40%) individuals fulfilled all the entry criteria and agreed to participate. Of the 54 cases, 53 had at least one medical/surgical procedure and/or invasive dental work; 46 (85%) had dental extractions, 19 (35.2%) had complex dental work, e.g. root canal, 44 (82%) had an operation requiring general anaesthesia, 41 (75.9%) had a procedure requiring local anaesthetic, and a number of endoscopic procedures were reported: gastroscopy (n=3), colonoscopy (n=3), laparoscopy (n=4), arthroscopy (n=5), cystoscopy (n=2).
  
  
  CONCLUSIONS
  We have documented exposure to medica/surgical procedures among HCV patients with no previously recognised mode of transmission.
  
  
  CONCLUSIONS
  The findings of this study have important public health implications for current cleaning, disinfection and sterilisation procedures and protocols (or lack of these) as well as for the policies and guidelines relating to the re-use of medical equipment such as multi-dose vials, suturing material and anaesthetic circuits.
authors.affiliation: claudia.trasancos@dhs.vic.gov.au
authors.forename: C C
authors.initials: CC
authors.lastname: Trasancos
authors.forename: M A
authors.initials: MA
authors.lastname: Kainer
authors.forename: P V
authors.initials: PV
authors.lastname: Desmond
authors.forename: H
authors.initials: H
authors.lastname: Kelly
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000635:transmission*; D003814:Dentistry, Operative; D015981:Epidemiologic Factors; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology / Q000635:transmission*; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D017757:Infectious Disease Transmission, Professional-to-Patient; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012725:Sexual Behavior; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology