Hospital admission is a relevant source of hepatitis C virus acquisition in Spain.
OBJECTIVE
Isolated cases of acute hepatitis C, as well as hepatitis C outbreaks transmitted by health-care related procedures, have drawn attention to nosocomial transmission of HCV. The aim of this study was to investigate the current relevance of nosocomial HCV infection.


METHODS
For this purpose, we performed a retrospective epidemiological analysis of all cases of acute hepatitis C diagnosed in 18 Spanish hospitals. Between 1998 and 2005, 109 cases were documented.


RESULTS
The most relevant risk factors registered during the 6-month period preceding the diagnosis of acute hepatitis C were: hospital admission in 73 (67%) cases, intravenous drug use in 9 (8%), accidental needlestick injury in 7 (6%) and sexual contact in 6 (5%). Among the 73 patients in whom hospital admission was the only risk factor, 33 underwent surgery and 24 were admitted to a medical emergency unit or a medical ward; the remaining 16 patients underwent an invasive diagnostic or therapeutic procedure. Sixty two patients underwent antiviral therapy and 51 (82%) achieved a sustained virological response. In 47 patients treatment was not indicated (in 24 due to spontaneous resolution of HCV infection).


CONCLUSIONS
In most patients with acute hepatitis C the only documented risk factor associated with the infection is hospital admission. These results stress the need for strict adherence to universal precaution measures. Fortunately, most cases of acute hepatitis C either resolve spontaneously or after antiviral therapy.
Martínez-Bauer
Eva
E
Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Ciber de Enfermedades Hepáticas y Digestivas, Ciberehd, Spain.
Forns
Xavier
X
Armelles
Mercé
M
Planas
Ramon
R
Solà
Ricard
R
Vergara
Mercé
M
Fàbregas
Silvia
S
Vega
Roser
R
Salmerón
Javier
J
Diago
Moisés
M
Sánchez-Tapias
Jose María
JM
Bruguera
Miquel
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D003428:Cross Infection / Q000453:epidemiology*; D004632:Emergency Medical Services; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000453:epidemiology* / Q000628:therapy / Q000635:transmission; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000235:genetics; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D012367:RNA, Viral