Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-12-01T01:40:21.406Z Has data issue: false hasContentIssue false

Hepatitis C Virus Infection in Healthcare Workers: Risk of Exposure and Infection

Published online by Cambridge University Press:  02 January 2015

Bruce P. Lanphear*
Affiliation:
Departments of Pediatrics, Community Medicine, and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
Calvin C. Linnemann Jr
Affiliation:
Departments of Internal Medicine, Pathology and Laboratory Medicine, and Environmental Health, University of Cincinnati
Constance G. Cannon
Affiliation:
Departments of Infection Control, University of Cincinnati Hospital, Cincinnati, Ohio
Martha M. DeRonde
Affiliation:
Medical Center Health Services, University of Cincinnati Hospital, Cincinnati, Ohio
Luann Pendy
Affiliation:
Abbott Laboratories, Abbott Park, Illinois
Lisa M. Kerley
Affiliation:
Abbott Laboratories, Abbott Park, Illinois
*
1425 Portland Ave., Department of Pediatrics, Rochester General Hospital, Rochester, NY 14621

Abstract

Objectives:

To determine the incidence of hepatitis C virus (HCV) infection among healthcare workers (HCWs) at a university hospital, the proportion of HCWs having non-A, non-B hepatitis (NANBH) who were anti-HCV positive, and the rate of HCV transmission following a HCV-positive needlestick injury.

Design:

Longitudinal analysis of a dynamic (cohort) population.

Measurements:

From 1980 through 1989, HCWs who had clinical NANBH were identified, and from 1987 through 1989, HCWs who reported a blood or body fluid exposure and the patients who were the source of the exposure were screened for antibodies to HCV.

Setting:

A 732-bed, university hospital and outpatient clinics.

Results:

Over the 10-year period, six cases of occupationally acquired NANBH were observed, for an incidence of 21 cases per 100,000 HCWs per year (standardized incidence ratio, 2.96; 95% confidence interval [CI95], 1.83 to 4.36). Four of the six cases were confirmed to be HCV infection. From 1987 through 1989, 176 (12.7%) of 1,387 patients who were the source of an exposure were anti-HCV positive. Exposures that occurred in the emergency department were more likely to be anti-HCV positive than were exposures from all other locations (relative risk [RR] = 1.7; P= 0.009). Of HCWs who had an HCV-positive needlestick injury and whose serum had been tested for anti-HCV at least 5 months after the exposure, 3 (6.0%) of 50 seroconverted. From 1987 through 1989, the incidence of HCV infection among HCWs was 54 cases per 100,000 HCWs per year.

Conclusion:

The incidence of clinical NANBH among HCWs in this study is approximately three times higher than that of non-HCWs. HCWs are at significant risk for exposure to and acquisition of HCV.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Prince, AM, Brotman, B, Grady, GE et al. Long-incubation post-transfusion hepatitis without serologic evidence of exposure to hepatitis-B virus, Lancet 1974;ii:241246.CrossRefGoogle Scholar
2. Alter, MJ, Hadler, SC, Judson, FN, et al. Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C virus infection. JAMA 1990;264:22312235.Google Scholar
3. Kuo, G, Choo, Q, Alter, HJ, et al. An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis. Science 1989;244:362364.CrossRefGoogle Scholar
4. Sodeyama, T Kiyosawa, K, Urushihara, A, et al. Detection of hepatitis C virus markers and hepatitis C virus genomic-RNA after needlestick accidents. Arch Intern Med 1993;153:15651572.Google Scholar
5. Vaglia, A, Nicolin, R, Puro, V, Ippolito, G, Bettini, C, de Lalla, F. Needlestick hepatitis C virus seroconversion in a surgeon. Lancet 1990;ii:13151316.CrossRefGoogle Scholar
6. Cariani, E, Zonaro, A, Primi, D, et al. Detection of HCV RNA and antibodies to HCV after a needlestick injury. Luncet 1991;i:850.CrossRefGoogle Scholar
7. Schlipkoter, U, Roggendorf, M, Cholmakow, K, Weise, A, Deinhardt, F. Transmission of hepatitis C virus (HCV) from a haemodialysis patient to a medical staff member. Sand J Infect Dis 1990;22:757758.CrossRefGoogle ScholarPubMed
8. Seeff, LB. Hepatitis C from a needlestick injury. Ann Intern Med 1991;115:411.CrossRefGoogle ScholarPubMed
9. Mitsui, T Iwano, K, Masuko, K, et al. Hepatitis C virus infection in medical personnel after needlestick accident. Hepatology 1992;16:11091114.Google Scholar
10. Wormser, GP Forseter, G, Joline, C, Tupper, B, O’Brien, TA. Hepatitis C infection in the health care setting. Low risk from parenteral exposure to blood of human immunodeticiency virus-infected patients. Am J Infect Control 1991;19:237242.CrossRefGoogle Scholar
11. Cooper, SW, Krusell, A, Tilton, RC, Goodwin, R, Levitz, RE. Seroprevalence of antibodies to hepatitis C virus in high-risk hospital personnel. Infect Control Hosp Epidemiol 1992;13:8285.CrossRefGoogle ScholarPubMed
12. Thomas, DL, Factor, SH, Kelen, GD, Washington, AS, Taylor, E, Quinn, TC. Viral hepatitis in health care personnel at the Johns Hopkins Hospital. Arch Intern Med 1993;153:17051712.CrossRefGoogle ScholarPubMed
13. Polish, LB, Tong, MJ, Co, RL, Coleman, PJ, Alter, MJ. Risk factors for hepatitis C virus infection among health care personnel in a community hospital. Am J Infect Control 1993;21:196200.Google Scholar
14. Vallari, DS, Jett, SW, Alter, HJ, Mimms, LT, Holzman, R, Shih, JW-K. Serologic markers of post-transfusion hepatitis C viral infection. J Clin Microbial 1992;30:552556.CrossRefGoogle Scholar
15. Vandenbroucke, JP. A shortcut method for calculating the 95 percent confidence interval of the standardized mortality ratio. Am J Epidemiol 1982:115:303304.Google Scholar
16. Alter, MJ, Gerety, RJ, Smallwood, LA, et al. Sporadic non-A, non-B hepatitis: frequency and epidemiology in an urban U.S. population. J Infect Dis 1982;145:886893.CrossRefGoogle Scholar
17. Craig, FE, Harrison, CR. Epidemiology of acute non-A, non-B hepatitis in a large county hospital outpatient population. Luborutory Medicine 1991;22:401404.Google Scholar
18. Kelen, GD, Green, GB, Purcell, RH, et al. Hepatitis B and hepatitis C in emergency department patients. N Engl J Med 1992;326: 13991404.Google Scholar
19. Read, AE, Donegan, E, Lake, J, et al. Hepatitis C in patients undergoing liver transplantation. Ann Intern Med 1991:282284.Google Scholar
20. Heumer, HP Prodinger, WM, Larcher, C, Most, J, Dierich MP Correlation of hepatitis C virus antibodies with HIV-1 seropositivity in intravenous drug addicts. Infection 1990;18:122.CrossRefGoogle Scholar
21. Lanphear, BP, Linnemann, CC Jr, Cannon, CG, DeRonde, MM. Decline of clinical hepatitis B in workers at a general hospital: relation to increasing vaccine-induced immunity. Clin Infect Dis 1993;16:1014.Google Scholar
22. Sugitani, M, Inchauspe, G, Shindo, M, Prince, AM. Sensitivity of serological assays to identify blood donors with hepatitis C viraemia. Lancet 1992;339:10181019.Google Scholar
23. Klein, RS, Freeman, K, Taylor, PE, Stevens, CE. Occupational risk for hepatitis C virus infection among New York City dentists. Lancet 1991;338:15391542.Google Scholar
24. Gerberding, JL, Henderson, DK. Management of occupational exposures to bloodborne pathogens: hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. 1992;14:11791185.Google ScholarPubMed