title: Acute hepatitis C virus infection in a nurse trainee following a needlestick injury.
abstract: Hepatitis C virus (HCV) infection after biological accident (needlestick injury) is a rare event. This report describes the first case of acute HCV infection after a needlestick injury in a female nursing student at Padua University Hospital. The student nurse was injured on the second finger of the right hand when recapping a 23-gauge needle after taking a blood sample. The patient who was the source was a 72-year-old female with weakly positive anti-HCV test results. Three months after the injury, at the second step of follow-up, a relevant increase in transaminases with a low viral replication activity (350 IU/mL) was observed in the student, indicating HCV infection. The patient tested positive for the same genotype (1b) of HCV as the injured student. A rapid decline in transaminases, which was not accompanied by viral clearance, and persistently positive HCV-RNA was described 1 mo later. Six months after testing positive for HCV, the student was treated with pegylated interferon plus ribavirin for 24 wk. A rapid virological response was observed after 4 wk of treatment, and a sustained virological response (SVR) was evident 6 mo after therapy withdrawal, confirming that the patient was definitively cured. Despite the favourable IL28B gene (rs12979860) CC- polymorphism observed in the patient, which is usually predictive of a spontaneous clearance and SVR, spontaneous viral clearance did not take place; however, infection with this genotype was promising for a sustained virological response after therapy.
authors: Department of Infectious and Tropical Diseases, Padua Hospital, I-35128 Padua, Italy.
authors: Renzo
authors: R
authors: Scaggiante
authors: Liliana
authors: L
authors: Chemello
authors: Roberto
authors: R
authors: Rinaldi
authors: Giovanni Battista
authors: GB
authors: Bartolucci
authors: Andrea
authors: A
authors: Trevisan
mesh_terms: D000208:Acute Disease; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001800:Blood Specimen Collection / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D016602:Needlestick Injuries; D009784:Occupational Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D013338:Students, Nursing; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a
keywords: Acute hepatitis; Antiviral therapy; Biological risk; Hepatitis C infection; Occupational exposure
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