Risk of hepatitis C virus transmission following percutaneous exposure in healthcare workers.
BACKGROUND
We wanted to determine the incidence of anti-hepatitis C virus (HCV) seroconversion after percutaneous exposure to infectious fluids of an anti-HCV positive source in healthcare workers (HCW) and to investigate related risk factors.


METHODS
Prospective observation in 55 Italian hospitals of anti-HCV-negative exposed HCW were followed clinically and serologically for at least 6 months.


RESULTS
Of 4,403 exposed HCW, 14 seroconverted (0.31%; 95% CI 0.15-0.48) after an injury with a hollow-bore, blood-filled needle (14/1,876=0.74%; 95% CI 0.41-1.25). Deep injuries increased the seroconversion risk (OR 6.53; 95% CI 2.01-20.80). Exposure to an HIV co-infected source was associated with an higher, though not yet statistically significant, risk (OR 2.76, 95% CI 0.49-10.77). Source's HCV viremia was available in 674 cases, 566 of whom tested positive, including the nine seroconversion cases for whom this information was available.


CONCLUSIONS
The risk of acquiring HCV after percutaneous exposure seems to be lower than previously reported. Deep injury, injury with a blood-filled needle and HIV co-infection of source seem to be associated with occupational transmission. Needlestick prevention devices could decrease the risk of infection with HCV and other bloodborne pathogens in HCW.
De Carli
G
G
Dept. of Epidemiology, National Institute for Infectious Diseases, Lazzaro Spallanzani-IRCCS, Via Portuense 292, I-00149 Rome, Italy. siroh@inmi.it
Puro
V
V
Ippolito
G
G
D005260:Female; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000635:transmission*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control; D017758:Infectious Disease Transmission, Patient-to-Professional; D007558:Italy / Q000453:epidemiology; D008297:Male; D016602:Needlestick Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors