Risk factors for hepatitis C virus transmission to health care workers after occupational exposure: a European case-control study.
BACKGROUND
Additional studies are required to identify risk factors for hepatitis C virus (HCV) transmission to health care workers after occupational exposure to HCV.


METHODS
We conducted a matched case-control study in 5 European countries from 1 January 1991 through 31 December 2002. Case patients were health care workers who experienced seroconversion after percutaneous or mucocutaneous exposure to HCV. Control subjects were HCV-exposed health care workers who did not experience seroconversion and were matched with case patients for center and period of exposure.


RESULTS
Sixty case patients and 204 control subjects were included in the study. All case patients were exposed to HCV-infected fluids through percutaneous injuries. The 37 case patients for whom information was available were exposed to viremic source patients. As risk factors for HCV infection, multivariate analysis identified needle placement in a source patient's vein or artery (odds ratio [OR], 100.1; 95% confidence interval [CI], 7.3-1365.7), deep injury (OR, 155.2; 95% CI, 7.1-3417.2), and sex of the health care worker (OR for male vs. female, 3.1; 95% CI, 1.0-10.0). Source patient HCV load was not introduced in the multivariate model. In unmatched univariate analysis, the risk of HCV transmission increased 11-fold for health care workers exposed to source patients with a viral load >6 log(10) copies/mL (95% CI, 1.1-114.1), compared with exposures to source patients with a viral load < or =4 log10 copies/mL.


CONCLUSIONS
In this study, HCV occupational transmission was found to occur after percutaneous exposures. The risk of HCV transmission after percutaneous exposure increased with deep injuries and procedures involving hollow-bore needle placement in the source patient's vein or artery. These results highlight the need for widespread adoption of needlestick-prevention devices in health care settings, together with other preventive measures.
Yazdanpanah
Y
Y
Service des Maladies Infectieuses et du Voyageur, Centre Hospitalier de Tourcoing, Faculté de Médecine de Lille, Tourcoing, France. yyazdan@yahoo.com
De Carli
G
G
Migueres
B
B
Lot
F
F
Campins
M
M
Colombo
C
C
Thomas
T
T
Deuffic-Burban
S
S
Prevot
M H
MH
Domart
M
M
Tarantola
A
A
Abiteboul
D
D
Deny
P
P
Pol
S
S
Desenclos
J C
JC
Puro
V
V
Bouvet
E
E
D000328:Adult; D016022:Case-Control Studies; D005060:Europe; D005260:Female; D006282:Health Personnel; D006526:Hepatitis C / Q000635:transmission*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016602:Needlestick Injuries; D016273:Occupational Exposure; D012307:Risk Factors; D013997:Time Factors