title: Frequent transient hepatitis C viremia without seroconversion among healthcare workers in Cairo, Egypt.
abstract: BACKGROUND
  With 10% of the general population aged 15-59 years chronically infected with hepatitis C virus (HCV), Egypt is the country with the highest HCV prevalence worldwide. Healthcare workers (HCWs) are therefore at particularly high risk of HCV infection. Our aim was to study HCV infection risk after occupational blood exposure among HCWs in Cairo.
  
  
  RESULTS
  The study was conducted in 2008-2010 at Ain Shams University Hospital, Cairo. HCWs reporting an occupational blood exposure at screening, having neither anti-HCV antibodies (anti-HCV) nor HCV RNA, and exposed to a HCV RNA positive patient, were enrolled in a 6-month prospective cohort with follow-up visits at weeks 2, 4, 8, 12 and 24. During follow-up, anti-HCV, HCV RNA and ALT were tested. Among 597 HCWs who reported a blood exposure, anti-HCV prevalence at screening was 7.2%, not different from that of the general population of Cairo after age-standardization (11.6% and 10.4% respectively, p = 0.62). The proportion of HCV viremia among index patients was 37%. Of 73 HCWs exposed to HCV RNA from index patients, nine (12.3%; 95%CI, 5.8-22.1%) presented transient viremia, the majority of which occurred within the first two weeks after exposure. None of the workers presented seroconversion or elevation of ALT.
  
  
  CONCLUSIONS
  HCWs of a general University hospital in Cairo were exposed to a highly viremic patient population. They experienced frequent occupational blood exposures, particularly in early stages of training. These exposures resulted in transient viremic episodes without established infection. These findings call for further investigation of potential immune protection against HCV persistence in this high risk group.
authors.affiliation: Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France. aline.munier@pasteur.fr
authors.forename: Aline
authors.initials: A
authors.lastname: Munier
authors.forename: Diaa
authors.initials: D
authors.lastname: Marzouk
authors.forename: Florence
authors.initials: F
authors.lastname: Abravanel
authors.forename: Mai
authors.initials: M
authors.lastname: El-Daly
authors.forename: Sylvia
authors.initials: S
authors.lastname: Taylor
authors.forename: Rasha
authors.initials: R
authors.lastname: Mamdouh
authors.forename: Waleed Salah
authors.initials: WS
authors.lastname: Eldin
authors.forename: Hanan Ezz
authors.initials: HE
authors.lastname: El-Arab
authors.forename: Dalia Gaber
authors.initials: DG
authors.lastname: Sos
authors.forename: Mohamed
authors.initials: M
authors.lastname: Momen
authors.forename: Omar
authors.initials: O
authors.lastname: Okasha
authors.forename: Lenaig
authors.initials: L
authors.lastname: Le Fouler
authors.forename: Mostafa
authors.initials: M
authors.lastname: El-Hosini
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
authors.forename: Mona
authors.initials: M
authors.lastname: Rafik
authors.forename: Matthew
authors.initials: M
authors.lastname: Albert
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Hamid
authors.forename: Mostafa Kamal
authors.initials: MK
authors.lastname: Mohamed
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Delarocque-Astagneau
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fontanet
mesh_terms: D000328:Adult; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000706:statistics & numerical data; D014766:Viremia / Q000097:blood / Q000453:epidemiology* / Q000635:transmission*; D055815:Young Adult