title: Digestive endoscopy is not a major risk factor for transmitting hepatitis C virus.
abstract: BACKGROUND
  The potential role of digestive endoscopy as a mode for transmission of hepatitis C virus (HCV) is controversial.
  
  
  OBJECTIVE
  To evaluate the role of digestive endoscopy in transmitting HCV by comparing the incidence of HCV infection in a cohort of patients undergoing endoscopy and in a cohort of blood donors.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  3 endoscopic units and 2 blood banks in northwestern Italy.
  
  
  METHODS
  The potentially exposed cohort consisted of 9188 outpatients consecutively recruited from 3 endoscopic units. Of 9008 patients negative for antibody to HCV (anti-HCV), 8260 (92%) were retested for anti-HCV 6 months after endoscopy. The unexposed cohort consisted of 51,230 healthy, anti-HCV-negative persons who donated blood at 2 blood banks in the same area and during the same time period; 38,280 of them (75%) were tested again for anti-HCV 6 to 48 months after the first blood donation (95,317 person-years of observation).
  
  
  METHODS
  Differences in the anti-HCV seroconversion rate between the exposed cohort (patients undergoing endoscopy) and the unexposed cohort (blood donors). Seroconversion was evaluated by a third-generation enzyme immunoassay for anti-HCV; persons positive for anti-HCV were tested for HCV RNA by polymerase chain reaction.
  
  
  RESULTS
  All 8260 persons undergoing endoscopy remained negative for anti-HCV 6 months after the procedure (risk per 1000 persons, 0 [95% CI, 0 to 0.465]); in particular, none of the 912 patients who underwent endoscopy with the same instrument previously used on HCV carriers showed anti-HCV seroconversion (risk per 1000 persons, 0 [CI, 0 to 4.195]). Four blood donors became positive for anti-HCV and HCV RNA (mean follow-up, 2.49 years; 0.042 case per 1000 person-years [CI, 0.011 to 0.107 case per 1000 person-years]); each had undergone minor surgery before the second test.
  
  
  CONCLUSIONS
  In the endoscopy cohort, 8.3% of patients were lost to follow-up.
  
  
  CONCLUSIONS
  These findings support the hypothesis that properly performed digestive endoscopy is not a major risk factor for the transmission of HCV.
authors.affiliation: Ospedale Molinette, Banca del Sangue e del Plasma della città di Torino, Torino, Italy. g.saracco@tin.it
authors.forename: Alessia
authors.initials: A
authors.lastname: Ciancio
authors.forename: Paola
authors.initials: P
authors.lastname: Manzini
authors.forename: Franco
authors.initials: F
authors.lastname: Castagno
authors.forename: Sergio
authors.initials: S
authors.lastname: D'Antico
authors.forename: Paolo
authors.initials: P
authors.lastname: Reynaudo
authors.forename: Laura
authors.initials: L
authors.lastname: Coucourde
authors.forename: Giovannino
authors.initials: G
authors.lastname: Ciccone
authors.forename: Mario
authors.initials: M
authors.lastname: Del Piano
authors.forename: Marco
authors.initials: M
authors.lastname: Ballarè
authors.forename: Sergio
authors.initials: S
authors.lastname: Peyre
authors.forename: Roberto
authors.initials: R
authors.lastname: Rizzi
authors.forename: Claudio
authors.initials: C
authors.lastname: Barletti
authors.forename: Mauro
authors.initials: M
authors.lastname: Bruno
authors.forename: Stefania
authors.initials: S
authors.lastname: Caronna
authors.forename: Patrizia
authors.initials: P
authors.lastname: Carucci
authors.forename: Wilma De Bernardi
authors.initials: Wde B
authors.lastname: Venon
authors.forename: Claudio
authors.initials: C
authors.lastname: De Angelis
authors.forename: Anna
authors.initials: A
authors.lastname: Morgando
authors.forename: Alessandro
authors.initials: A
authors.lastname: Musso
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
authors.forename: Mario
authors.initials: M
authors.lastname: Rizzetto
authors.forename: Giorgio
authors.initials: G
authors.lastname: Saracco
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000592:standards; D001782:Blood Donors; D016099:Endoscopy, Gastrointestinal / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000592:standards; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral