A physician with a positive hepatitis C virus RNA test after a needlestick injury.
Needlestick accidents continue to be a hazard for healthcare workers. We report the development of acute hepatitis C infection in a physician after needlestick injury. Hepatitis C virus (HCV)-RNA, seroconversion and a raised plasma alanine aminotransferase (ALAT) level were found in plasma three months after the accident. Treatment with interferon alfa and ribavirin was started. While the physician was on treatment, HCV-RNA test results from plasma taken the day treatment was started became available. HCV-RNA was undetectable by quantitative bDNA assay, undetectable by qualitative polymerase chain reaction (PCR) and undetectable by transcription mediated amplification (TMA). A dilemma arose at this point: should the patient stop the treatment or continue the planned therapy? The physician decided to continue a 24-week course of treatment. Six months after the end of treatment, the physician was still HCV-RNA-negative and with a normal plasma ALAT level. The rationale of the decision to continue therapy is discussed. This information may be useful for clinicians confronted with a similar dilemma.
Weegink
Christine J
CJ
Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands. c.j.weegink@amc.uva.nl
Sentjens
Roel E
RE
Van Der Heyden
Jeroen F
JF
Chamuleau
Robert A
RA
Tytgat
Guido N
GN
Beld
Marcel G
MG
D000208:Acute Disease; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000188:drug therapy / Q000635:transmission* / Q000821:virology; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D008134:Long-Term Care / Q000379:methods; D008297:Male; D008505:Medical Staff, Hospital; D016602:Needlestick Injuries / Q000150:complications*; D012367:RNA, Viral / Q000097:blood*
D000998:Antiviral Agents; D012367:RNA, Viral