Managing Occupational Risks for Hepatitis C Transmission in the Health Care Setting

Abstract

Hepatitis C virus (HCV) infection is a significant contemporary health problem in the United States and elsewhere. Because it is primarily transmitted via blood, hepatitis C infection presents risks for both nosocomial transmission to patients and occupational spread to health care workers. Recent insights into the pathogenesis, immunopathogenesis, natural history, and treatment of infection caused by this unique flavivirus provide a rationale for the use of new strategies for managing occupational hepatitis C infections when they occur. This article reviews this developing information. Recently published data demonstrate success rates in the treatment of “acute hepatitis C syndrome” that approach 100\%, and although these studies are not directly applicable to all occupational infections, they may provide important clues to optimal management strategies. In addition, the article delineates approaches to the prevention of occupational exposures and also addresses the difficult issue of managing HCV-infected health care providers. The article summarizes currently available data about the nosocomial epidemiology of HCV infection and the magnitude of risk and discusses several alternatives for managing exposure and infection. No evidence supports the use of immediate postexposure prophylaxis with immunoglobulin, immunomodulators, or antiviral agents. Based on the very limited data available, the watchful waiting and preemptive therapy strategies described in detail in this article represent reasonable interim approaches to the complex problem of managing occupational HCV infections, at least until more definitive data are obtained

Acidentes de trabalho com exposição a material biológico: Descrição dos casos na Bahia

“…4,5 O risco de infecção por HIV pós-exposição ocupacional percutânea com sangue contaminado é de aproximadamente 0,3%, pelo vírus do HBV varia de 6-30% e chega até a 60%, e o HCV é de aproximadamente 1,8%, mas esta taxa depende do paciente-fonte entre outros fatores relacionados a contaminação. [6][7][8] O Ministério da Saúde (MS) elaborou um protocolo de condutas pós-exposição a materiais biológicos no qual descreve os principais procedimentos a serem adotados após o acidente, como os cuidados com a área exposta, avaliação do acidente (material orgânico, tipo de contato, conhecimento da fonte), orientações e aconselhamento ao acidentado (sorologia da fonte e do acidentado, situação do acidente) e notificação do acidente. 9,10 O acidente de trabalho com exposição a material biológico acomete profissionais de diferentes ocupações, como trabalhadores da saúde, serviços de limpeza, pesquisadores, estudantes, profissionais das ciências sociais e humanas entre outras ocupações, e todos devem ser notificados no Sistema de Informação de Agravos de Notificação (SINAN), assim como deve ser emitida a Comunicação de Acidente de Trabalho (CAT) para fortalecer estas informações e contribuir para medidas e políticas públicas eficientes e eficazes.…”

Occupational Deaths among Healthcare Workers

“…Healthcare workers as a group have the same hepatitis C virus seroprevalence as the rest of the US population (20). However, transmission from a hepatitis C-infected patient to a healthcare worker occurs in 1%-3% of percutaneous exposures (22). With an estimated 380,000 percutaneous injuries annually (23), 50-150 transmissions would be expected, assuming that hospitalized patients have the same hepatitis C virus seroprevalence as the rest of the US population.…”

Untitled

“…Babies born to infected mothers are at very high risk of to becoming carriers and developing liver pathology. (Henderson, 2003) …”

“…(Vandelli, et al, 2004) The most significant risk behavior for HCV infection is drug use, particularly I.V. and is responsible for about 30-40% of all identified cases of hepatitis C. the sharing of contaminated needles and other drug paraphernalia increases the chance of infection dramatically Cocaine users have also been shown to transmit the virus by sharing snorting straws (Henderson, 2003).…”