Frequent patient-to-patient transmission of hepatitis C virus in a haematology ward

Allander, Tobias; Gruber, Astrid; Beyene, Aster; Björkholm, Magnus; Persson, Mats A. A.; Naghavi, Mojgan H.; Söderstöm, T.; Grillner, Lena

doi:10.1016/s0140-6736(95)90518-9

Cited by 194 publications

(99 citation statements)

References 16 publications

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“…It should be emphasized that good medical practice is required to avoid patient-to-patient transmission of HCV. 34 Differences in the major mode of transmission account for the differences in anti-HCV prevalence between age and sex subgroups. All 21 anti-HCV positive cases with a history of IV drug abuse were õ40-years-old and 14 (67%) were men.…”

Section: Aid Hepa 0015mentioning

confidence: 99%

Hepatitis C in a French population-based survey, 1994: Seroprevalence, frequency of viremia, genotype distribution, and risk factors

et al. 1997

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AND THE COLLABORATIVE STUDY GROUP 4 drug abuse (21 cases, 14 men all õ 40-years-old), previous The aims of this study were the following: 1) to estitransfusion (22 cases, 18 women), and not having paid mate the prevalence of hepatitis C virus (HCV) antibody employment. Although routes of transmission other (anti-HCV) in a population-based survey of French resithan IV drug abuse and transfusion may not be formally dents not selected for risk factors; 2) to investigate the excluded they were not found to be statistically signifiassociation between anti-HCV seropositivity, viremia, cant. Hepatitis C appears to be a major public health the infecting HCV genotype, and the alanine transamiconcern in France. A more active screening policy may nase ( 1 The most serious conseprevalence of 1.15%. Fifty percent of these positive vol-quences of HCV result from chronic infection. However, the unteers also had an abnormal ALT level and 81% were development of an HCV carrier state without major liver HCV-RNA positive by polymerase chain reaction (PCR). anomalies as assessed by liver function tests is not uncomThe prevalence weighted for age, sex, and place of resi-mon and some patients with histological evidence of chronic dence was 1.05% (95% CI: 0.75-1.34). The weighted preva-active hepatitis or cirrhosis present minimal clinical evidence lence was lower among men ú 40-years-old (0.5%; 95% of liver disease.2,3 HCV infection is most commonly identified CI: 0.1-1.0) and was close to 1% in all other age and sex following diagnosis of chronic liver disease of 10 to 30 years groups. Prevalence was inversely correlated with socio-duration. 4 Surveys of overt clinical infections thus give a poor professional status with the highest rate being found estimate of the overall prevalence of HCV infection in the among those with no paid employment (2.2%; 95% CI: general population. Only seroprevalence studies using large 1.3-3.0). The HCV prevalence (1.7%; 95% CI: 1.0-2.3) was numbers of subjects not selected for risk factors can yield highest in southeastern France. Seventy-eight percent accurate information on the health burden associated with of positive intervenous (IV) drug abusers were infected HCV in the general population. Although long-term mortality with HCV genotypes 1a or 3, whereas 80% of the transfu-associated with chronic hepatitis C remains to be detersion-associated cases were infected by HCV genotypes mined, 5 prevalence data from representative surveys would 1b or 2a. Only three variables were significantly associ-help plan clinical and prevention activities. ated with HCV seropositivity in multivariate analysis: IV Most available information about HCV antibody (anti-HCV) seroprevalence in the French population are from studies of high risk groups, 6-8 blood donors (anti-HCV prevalence from 0.6% to 0.8% in 1991, 9,10 and 0.3% in 1994 11 ), and pregAbbreviations: HCV, hepatitis C virus; anti-HCV, HCV antibody; ELISA, enzyme-linked nant women (prevalence from 1% to 2%).12 immunosorbent assay; SIA, strip immunoblot assa...

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Section: Aid Hepa 0015mentioning

confidence: 99%

Hepatitis C in a French population-based survey, 1994: Seroprevalence, frequency of viremia, genotype distribution, and risk factors

et al. 1997

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“…For comparison, the distribution of risk factors recent reports showing HCV transmission between patients undergoing surgery on the same operating session 12 and in in the whole cohort of blood donors during the study period was as follows: 26.5% had parenteral exposure in a medical those treated in a hematology ward. 13 Possible mechanisms for nosocomial transmission must be analyzed in greater deor surgical setting; 8.2% were health care workers; 6.2% ad- for their own protection rather than for the prevention of…”

Section: 26mentioning

confidence: 99%

“…have been hypothesized as possible causes of infection. 2,8,[11][12][13][14][15] Innogenetics N.V., Zwijnaarde, Belgium), 19 which allows the identifiNo data are as yet available on the incidence of HCV infection cation of HCV types (from 1 to 5) and subtypes, following the classifiin subjects at low risk for blood-borne diseases. The duration of follow-up was expressed as the number of months logia, Ospedale Maggiore, Milano, Italy.…”

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confidence: 99%

The incidence and risk factors of community-acquired hepatitis C in a cohort of Italian blood donors

et al. 1997

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We performed a prospective study in a cohort of repeat To assess the incidence and source of community-acblood donors to estimate the risk of acquiring HCV infection quired hepatitis C virus (HCV) infection among subjects among individuals without parenteral exposure, and to invesat low risk for blood-borne diseases, we prospectively tigate the possible cause of infection. studied a cohort of 16,515 repeat blood donors over a mean follow-up time of 36 months. Second-and third-PATIENTS AND METHODS generation methods were used for hepatitis C virus antibody (anti-HCV) testing. HCV RNA was determined in A cohort of 18,109 anti-HCV-negative blood donors, candidates the serum of anti-HCV-positive donors by reverse-tran-for a second or subsequent donation, was enrolled between May 1991 scription polymerase chain reaction. Liver biopsy was and April 1992 in a longitudinal prospective study. Of this cohort, 16,515 subjects came to our center for further donations and were performed in the viremic subjects. Risk factors for HCV followed up for an average of 36 months (range, 3-52 months). The infection were identified by a psychosocial questionmedian interval between donations was 202 days. The male/female naire in the whole cohort. During follow-up, 5 donors ratio was 7:3, the median age was 32 years (range, 18-65 years). A became infected with HCV. The incidence was 1 per psychosocial questionnaire, based on 47 direct and indirect ques-10,000 person-years (95% confidence interval, 0.3-2.4 per tions, was routinely administered to blood donors. 16 Questions re-10,000). During the 6 months before seroconversion, four garded: 1) demographic information; 2) cigarette smoking and alcohol subjects (80%) underwent medical or surgical percutane-consumption; 3) drug use, with reference to type, frequency, and time ous procedures, compared with 26.5% in the entire donor of last assumption; 4) sexual history; 5) history of hepatitis; and 6) cohort (difference between frequencies, 53.5%; CI: 18.9-other risk factors for blood-borne infection (blood transfusion, tattooing, nosocomial exposure). At each donation, the clinical data The subjects showing confirmed anti-HCV reactivity were asked after seroconversion, and liver biopsy showed chronic to enter a follow-up program consisting of clinical and laboratory hepatitis in all cases. Thus, new cases of hepatitis C oc-evaluation, including HCV-RNA determination, at 1-to 3-month incur among individuals without a history of known risk tervals. A serum sample, collected on the blood donation preceding factors, some of which may be caused by nosocomial seroconversion, was retested for anti-HCV using a third-generation exposure. (HEPATOLOGY 1997;25:702-704.) test and was evaluated for HCV RNA. Liver biopsy was proposed to the viremic subjects. Sexual partners and household contacts of seroconverting subjects were invited for counseling and anti-HCV Chronic hepatitis C virus (HCV) infection represents a sig-testing. nificant cause of morbidity and mortality worldwide. 89.1). One seroconverti...

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“…9,10 Transmission of HCV in hemodialysis and hematology units is well documented. 6,11,12 Transfusion of blood products before universal anti-HCV screening and patient-to-patient transmission have been implicated as the main mechanisms of HCV acquisition in this setting. [12][13][14][15] The latter mechanism was suspected by the greater incidence of HCV transmission in units with higher prevalence of HCV infection and has been unequivocally demonstrated by molecular analysis of HCV isolates.…”

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confidence: 99%

Nosocomial transmission of HCV in the liver unit of a tertiary care center

et al. 2004

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Despite its medical and legal implications, there are no prospective studies analyzing the incidence and mechanisms involved in the nosocomial transmission of hepatitis C virus (HCV) in liver units. This study prospectively investigates the nosocomial transmission of HCV in the liver unit of a tertiary care center from August 2000 to October 2002. The median prevalence of HCV infection among hospitalized patients was 50%. Anti-HCVnegative patients admitted to the liver unit during the study period were prospectively followed, and serum markers of HCV infection were repeated 6 months after discharge.

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Frequent patient-to-patient transmission of hepatitis C virus in a haematology ward

Cited by 194 publications

References 16 publications

Hepatitis C in a French population-based survey, 1994: Seroprevalence, frequency of viremia, genotype distribution, and risk factors

Hepatitis C in a French population-based survey, 1994: Seroprevalence, frequency of viremia, genotype distribution, and risk factors

The incidence and risk factors of community-acquired hepatitis C in a cohort of Italian blood donors

Nosocomial transmission of HCV in the liver unit of a tertiary care center

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