Needlestick transmission of hepatitis C.
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 alpha 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 and treatment.
Sulkowski
Mark S
MS
Johns Hopkins School of Medicine, 424 N Bond St, Baltimore, MD 21231, USA.
Ray
Stuart C
SC
Thomas
David L
DL
D000062:Accidents, Occupational; D000208:Acute Disease; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001247:Asthenia / Q000209:etiology; D005076:Exanthema / Q000209:etiology; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D007396:Internship and Residency; D019259:Lamivudine / Q000627:therapeutic use; D016602:Needlestick Injuries / Q000517:prevention & control; D019888:Nelfinavir / Q000627:therapeutic use; D016273:Occupational Exposure / Q000517:prevention & control; D010820:Physicians; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D014766:Viremia / Q000175:diagnosis / Q000188:drug therapy; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D000998:Antiviral Agents; D018937:Hepatitis C Antibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D019259:Lamivudine; D011092:Polyethylene Glycols; D012254:Ribavirin; D015215:Zidovudine; D019888:Nelfinavir; C100416:peginterferon alfa-2a