Risk of Transmission and Features of Hepatitis C After Needlestick Injuries

1999 ◽  
Vol 20 (01) ◽  
pp. 63-64 ◽  
Author(s):  
Saeed S. Hamid ◽  
Badar Farooqui ◽  
Qudsia Rizvi ◽  
Tarranum Sultana ◽  
Anwar A. Siddiqui
Keyword(s):  
Hepatitis C ◽  
Healthcare Workers ◽  
Cost Effective ◽  
Asymptomatic Infection ◽  
Needlestick Injury ◽  
Hcv Rna ◽  
Needlestick Injuries ◽  
Cost Effective Method ◽  
Polymerase Chain

Abstract The rate of transmission and management of needlestick injuries from hepatitis C virus (HCV) patients to healthcare workers is still a matter of debate. We used a stringent protocol using monthly transaminase levels and polymerase chain reaction for HCV RNA to monitor 53 healthcare workers prospectively for up to 6 months following needle injuries from HCV-positive patients. Evidence of transmission of HCV was found in only 2 workers (4%) with mild asymptomatic infection, one of which resolved spontaneously. Based on our experience, we now use a less-intensive follow-up protocol. Further investigation is required to determine the most cost-effective method to monitor individuals who suffer a needlestick injury from an HCV-positive patient.

scholarly journals Evidence of hepatitis in patients receiving transfusions of blood components containing antibody to hepatitis C

Blood ◽  
1993 ◽  
Vol 82 (3) ◽  
pp. 1000-1005 ◽  
Author(s):  
SK Aoki ◽  
PV Holland ◽  
LP Fernando ◽  
IK Kuramoto ◽  
S Anderson ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Blood Components ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Immunoblot Assay ◽  
Polymerase Chain ◽  
Hepatitis C Virus Antibody

Abstract When hepatitis C virus antibody (anti-HCV) enzyme immunoassay (EIA1) testing became available in 1990, we tested samples from previously transfused blood units, traced the recipients of reactive units, and evaluated the recipients for HCV infection during the 12 months after transfusion. Ten of 42 recipients of EIA1-reactive blood were anti-HCV reactive on follow-up by EIA1 and 12 were reactive by a second- generation assay (EIA2). Reverse transcriptase-polymerase chain reaction (RT-PCR) detected HCV RNA in 5 seronegative recipients. In all, 17 of 42 recipients (40%) of EIA1-reactive blood had evidence of HCV infection. In comparison, 54 surgery patients, who received either no transfusion or autologous EIA1-nonreactive blood, remained EIA1 nonreactive and RT-PCR negative for 1 year; 1 patient (1.8%) became EIA2 reactive (P < or = .01). Of the recipients of anti-HVC reactive blood transfusions (reactive by both EIA1 and a supplemental 4-antigen strip immunoblot assay [RIBA2]), 14 (93%) of the recipients had evidence of HCV infection compared with only 3 of 27 recipients (11%) of EIA1-reactive, RIBA2-nonreactive blood (P < or = .01). Thus, blood components reactive for anti-HCV EIA1 may have transmitted HCV up to 40% of the time, but blood components found reactive by both EIA1 and RIBA2 may transmit HCV with a frequency of greater than 90%.

scholarly journals Evidence of hepatitis in patients receiving transfusions of blood components containing antibody to hepatitis C

Blood ◽  
1993 ◽  
Vol 82 (3) ◽  
pp. 1000-1005
Author(s):  
SK Aoki ◽  
PV Holland ◽  
LP Fernando ◽  
IK Kuramoto ◽  
S Anderson ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Blood Components ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Immunoblot Assay ◽  
Polymerase Chain ◽  
Hepatitis C Virus Antibody

When hepatitis C virus antibody (anti-HCV) enzyme immunoassay (EIA1) testing became available in 1990, we tested samples from previously transfused blood units, traced the recipients of reactive units, and evaluated the recipients for HCV infection during the 12 months after transfusion. Ten of 42 recipients of EIA1-reactive blood were anti-HCV reactive on follow-up by EIA1 and 12 were reactive by a second- generation assay (EIA2). Reverse transcriptase-polymerase chain reaction (RT-PCR) detected HCV RNA in 5 seronegative recipients. In all, 17 of 42 recipients (40%) of EIA1-reactive blood had evidence of HCV infection. In comparison, 54 surgery patients, who received either no transfusion or autologous EIA1-nonreactive blood, remained EIA1 nonreactive and RT-PCR negative for 1 year; 1 patient (1.8%) became EIA2 reactive (P < or = .01). Of the recipients of anti-HVC reactive blood transfusions (reactive by both EIA1 and a supplemental 4-antigen strip immunoblot assay [RIBA2]), 14 (93%) of the recipients had evidence of HCV infection compared with only 3 of 27 recipients (11%) of EIA1-reactive, RIBA2-nonreactive blood (P < or = .01). Thus, blood components reactive for anti-HCV EIA1 may have transmitted HCV up to 40% of the time, but blood components found reactive by both EIA1 and RIBA2 may transmit HCV with a frequency of greater than 90%.

scholarly journals Antiviral Effect of Interferon Therapy for Patients with Chronic Hepatitis C

1992 ◽  
Vol 3 (5) ◽  
pp. 305-309 ◽  
Author(s):  
J. Hayashi ◽  
K. Nakashima ◽  
A. Noguchi ◽  
M. Hirata ◽  
K. Akazawa ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Antiviral Effect ◽  
Hcv Rna ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Lymphoblastoid Interferon

Thirty-two patients with chronic hepatitis who were positive for hepatitis C virus (HCV) RNA by polymerase chain reaction and had antibody to HCV (anti-HCV), were enrolled in this study. Twenty of them were also positive for antibody to the GOR epitope (anti-GOR). Sixteen of the enrolled patients were treated with human lymphoblastoid interferon for six months. Treatment was initiated with 3 million units of interferon daily for 2 weeks, followed by 3 million units three times a week for 6 weeks and 1.5 million units three times a week for 16 weeks. The efficacy of therapy was assessed by comparison with the results in 16 untreated patients. Aminotransferase values, titre of anti-HCV and anti-GOR antibodies showed significant decreases throughout the therapy compared with baseline levels and the untreated patients. After a 3 month follow-up, nine treated patients (56.3%) had normal aminotransferase activities and six of them eliminated HCV RNA from their sera (37.5%). Three of these six patients became negative for both anti-HCV and anti-GOR antibodies (18.8%). None of the untreated control patients had normal aminotransferase activities or became negative for HCV markers. The present study suggests that human lymphoblastoid interferon can control the disease activity and eliminate hepatitis C virus from patients with chronic hepatitis C.

Innovative Solution to Sharp Waste Management in a Tertiary Care Hospital in Karachi, Pakistan

2013 ◽  
Vol 34 (12) ◽  
pp. 1297-1305 ◽  
Author(s):  
Seher Qaiser ◽  
Ambreen Arif ◽  
Saeed Quaid ◽  
Tasnim Ahsan ◽  
Kashif Riaz ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Needlestick Injury ◽  
Care Hospital ◽  
Transmission Cycle ◽  
Innovative Solution ◽  
Injection Safety

Background.Prevalence of hepatitis B and C in Pakistan is 2.5% and 4.5%, respectively. Major cause of these infections is reuse of syringes.Objective.To determine a cost-effective, innovative solution to prevent syringe reuse and break the transmission cycle of blood-borne infections.Study Design, Settings, and Duration.Analytical study in a tertiary care hospital, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, July 2011 to June 2012.Methods.Healthcare workers from 30 wards included in the study were trained on injection safety, use of needle remover and needle pit, and management of needlestick injuries. Each ward was provided with 2 needle-removing devices, and a pit was constructed for disposal of needles. Usage of the device in wards and pit use were monitored regularly.Results.In 28 (93.3%) wards, sharp containers were accessible by public and were slack. Syringes were recapped using both hands in 27 (90%) cases; needlestick injury was reported by 30% of paramedics, while 25 (83.3%) of the interviewed staff had not received any formal training in injection safety. Vigilant monitoring and information sharing led to healthcare workers in 28 (96.5%) wards using the device. Needle containers were emptied in 27 (93.1%) wards, and needle pits were used in 26 (96.3%) wards. Needlestick injury was nil in follow-up.Conclusions.Needle removers permanently disable syringes. The needle pit served as a cost-effective, innovative method for disposal of needles. The intervention resulted in reducing the risk of needlestick injury.

Late Appearance of Hepatitis C Virus RNA After Needlestick Injury: Necessity for a More Intensive Follow-Up

2009 ◽  
Vol 30 (3) ◽  
pp. 299-300 ◽  
Author(s):  
Norbert H. Gruener ◽  
Malte Heeg ◽  
Martin Obermeier ◽  
Axel Ulsenheimer ◽  
Bijan Raziorrouh ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Needlestick Injury ◽  
Hepatitis C Virus Rna ◽  
Virus Rna

Hepatitis C Virus Seromarkers and Subsequent Risk of Hepatocellular Carcinoma: Long-Term Predictors From a Community-Based Cohort Study

2010 ◽  
Vol 28 (30) ◽  
pp. 4587-4593 ◽  
Author(s):  
Lee Mei-Hsuan ◽  
Hwai-I Yang ◽  
Sheng-Nan Lu ◽  
Chin-Lan Jen ◽  
Shiou-Hwei Yeh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Elevated Serum ◽  
Hcv Rna ◽  
Genotype 1 ◽  
Hcv Genotype ◽  
Hcv Genotype 1 ◽  
Carcinoma Risk

Purpose Hepatitis C virus (HCV) contributes to one third of hepatocellular carcinoma cases worldwide. Long-term predictors for HCV-related hepatocellular carcinoma are essential for early intervention. Serum HCV RNA and ALT levels and HCV genotype were assessed for their predictability of hepatocellular carcinoma risk. Methods A prospective cohort of 925 participants positive for antibodies against HCV and age 30 to 65 years was recruited and followed from 1991 to 2006. Serum HCV RNA and ALT levels and HCV genotypes at enrollment and during follow-up were examined. Newly developed hepatocellular carcinoma was identified by health examination and computerized linkage with national cancer registration and death certification profiles. Multivariate adjusted hazard ratios with 95% CIs were estimated using Cox regression models. Results Fifty-five participants newly developed hepatocellular carcinoma during 8,476 person-years of follow-up, giving an incidence rate of 648.9 per 100,000 person-years. The cumulative hepatocellular carcinoma risk increased from 1.1% for HCV RNA seronegative status to 6.4% for low HCV RNA levels and to 14.7% for high HCV RNA levels (P < .001). The cumulative risk also increased with elevated serum ALT levels from 1.7% for persistently ≤ 15 U/L to 4.2% for ever more than 15 U/L but never more than 45 U/L and to 13.8% for ALT ever ≥ 45 U/L (P < .001). Having HCV genotype 1 was associated with a higher cumulative hepatocellular carcinoma risk (12.6%) than not having HCV genotype 1 (4.5%; P < .001). Conclusion Elevated serum levels of HCV RNA and ALT and HCV genotype 1 infection are independent risk predictors of hepatocellular carcinoma. These findings have strong implications for the management of chronic HCV.

scholarly journals Hepatitis C elimination in the Netherlands (CELINE): study protocol for nationwide retrieval of lost to follow-up patients with chronic hepatitis C

2020 ◽  
Vol 7 (1) ◽  
pp. e000396 ◽  
Author(s):  
Cas J Isfordink ◽  
Sylvia M Brakenhoff ◽  
Marleen van Dijk ◽  
Marc van der Valk ◽  
Rob J de Knegt ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
The Netherlands ◽  
Chronic Hepatitis C ◽  
Hcv Rna ◽  
Ethical Approval ◽  
Hcv Transmission ◽  
Chronic Hcv ◽  
Lost To Follow Up

BackgroundThe Netherlands has a low hepatitis C virus (HCV) prevalence, estimated at 0.16%. Previous studies have shown that up to 30% of the diagnosed HCV population in the Netherlands has been lost to follow-up (LTFU). Retrieval of these patients could halt progression of liver disease in infected patients, reduce the number of infected individuals and limit HCV transmission. Several regional Dutch retrieval projects have already been executed, which demonstrated that retrieval is feasible. Therefore, we initiated a nationwide retrieval project, aiming to achieve microelimination in previously diagnosed but LTFU patients with chronic HCV through retrieval.MethodsLaboratory records will be used to identify possible patients with chronic hepatitis C, defined as either a positive most recent HCV RNA or positive HCV antibodies without known RNA result. Reviewing patient records and obtaining current contact information from municipality databases will identify LTFU patients who are eligible for retrieval. These patients will be invited for outpatient clinic care. The primary outcome of the study is the total number of LTFU patients who have been successfully linked to care.DiscussionHepatitis C ELimination In the NEtherlands (CELINE) is within the remit of WHO elimination targets and the Dutch National Hepatitis Plan. The methodology of CELINE is based on previously conducted regional retrieval projects and is designed to overcome some of their limitations. After ethical approval was obtained in 2018, the first centre initiated retrieval in 2018 and the project is expected to finish in 2021.Trial registration numberNCT04208035.

Detection of active hepatitis C virus and hepatitis G virus/GB virus C replication in bone marrow in human subjects

Blood ◽  
2000 ◽  
Vol 95 (12) ◽  
pp. 3986-3989 ◽  
Author(s):  
Marek Radkowski ◽  
Joanna Kubicka ◽  
Elzbieta Kisiel ◽  
Janusz Cianciara ◽  
Marek Nowicki ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Human Subjects ◽  
Hcv Rna ◽  
Serum Samples ◽  
Hepatitis G Virus ◽  
Polymerase Chain ◽  
Hepatitis G ◽  
Virus C

Abstract We have analyzed the presence of hepatitis C virus (HCV) and hepatitis G virus (HGV) sequences in bone marrow and serum samples from 48 patients of a hematologic outpatient clinic. HCV RNA was detected in 18 (38%) and 15 (31%) and HGV RNA was detected in 6 (13%) and 9 (19%) of serum and bone marrow samples, respectively. In 3 patients, HGV RNA was detectable in bone marrow but not in the serum; 2 of these patients were negative for the presence of specific antibodies. Using a highly strand-specific Tth-based reverse transcriptase-polymerase chain reaction (RT-PCR), the presence of HCV RNA and HGV RNA negative strand was demonstrated in 4 and 5 bone marrow samples, respectively. Our study shows that HCV and HGV can replicate in bone marrow; in the case of HGV, analysis of serum may underestimate the true prevalence of infection.

scholarly journals New cost-effective pleural procedure training: manikin-based model to increase the confidence and competency in trainee medical officers

2019 ◽  
Vol 95 (1123) ◽  
pp. 245-250 ◽  
Author(s):  
Subash Heraganahally ◽  
Sumit Mehra ◽  
Daisy Veitch ◽  
Dimitar Sajkov ◽  
Henrik Falhammar ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Online Survey ◽  
Prospective Observational Study ◽  
Simulation Training ◽  
Cost Effective ◽  
Training Model ◽  
Further Training ◽  
Pleural Diseases ◽  
Cost Effective Method

Purpose of the studyPleural diseases are common in clinical practice. Doctors in training often encounter these patients and are expected to perform diagnostic and therapeutic pleural procedures with confidence and safely. However, pleural procedures can be associated with significant complications, especially when performed by less experienced. Structured training such as use of training manikin and procedural skills workshop may help trainee doctors to achieve competence. However, high costs involved in acquiring simulation technology or attending a workshop may be a hurdle. We hereby describe a training model using a simple manikin developed in our institution and provide an effective way to document skill acquisition and assessment among trainee medical officers.Study designThis was a prospective observational study. The need for training, competence and confidence of trainees in performing pleural procedures was assessed through an online survey. Trainees underwent structured simulation training through a simple manikin developed at our institute. Follow-up survey after the training was then performed to access confidence and competence in performing pleural procedures.ResultsForty-seven trainees responded to an online survey and 91% of those expressed that they would like further training in pleural procedure skills. 81% and 85% of responders, respectively, indicated preferred method of training is either practising on manikin or performing the procedure under supervision. Follow-up survey showed improvement in the confidence and competence.ConclusionOur pleural procedure training manikin model is a reliable, novel and cost-effective method for acquiring competences in pleural procedures.

Evaluation of HCV RNA by PCR and Signal-to-Cutoff Ratios of HCV Antibody Assays for Diagnosis of HCV Infection

2020 ◽  
Author(s):  
Myeong Hee Kim ◽  
So Young Kang ◽  
Woo In Lee ◽  
Min Young Lee
Keyword(s):  
Operating Characteristic ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Immunoblot Assay ◽  
Receiver Operating Characteristic Curves ◽  
Antibody Assays ◽  
Recombinant Immunoblot Assay ◽  
Hcv Antibody ◽  
Polymerase Chain

Abstract Objective In this study, we assessed whether a hepatitis C virus (HCV) RNA test could replace recombinant immunoblot assay (RIBA) and reduce unnecessary supplemental tests as the signal-to-cutoff (S/Co) ratio from anti-HCV antibody (Ab) tests. Methods Anti-HCV Ab tests were performed to screen for HCV infections, and RIBA and real-time polymerase chain reaction were performed for HCV RNA to confirm HCV infection. Receiver operating characteristic curves were evaluated to determine the optimal S/Co ratios for predicting HCV infection. Results The cutoff value for the S/Co ratio was 3.63 for predicting RIBA results and 10.6 for predicting HCV RNA results. Our data suggested that an S/Co ratio ≥10.6 indicated a high risk of active HCV infection. An S/Co ratio of 3.63 to 10.6 needed further evaluation and repeat HCV RNA testing. No further testing was required for S/Co ratios &lt;3.63 or ≥10.6. Conclusion We determined that the S/Co ratio of the anti-HCV Ab test provides useful information to confirm HCV infections, including the need for further laboratory testing or clinical follow-up.

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