hepatitis C transmission
Clinical bottom line
A transmission rate of 5%
would seem to be a sensible estimate for hepatitis C.
MS Sulkowski et al.
Needlestick transmission of hepatitis C. JAMA 2002 287: 2406-2413.
TY Wang et al. Use of
polymerase chain reaction for early detection and management of
hepatitis C virus infection after needlestick injury. Annals of
Clinical & Laboratory Science 2002 32: 137-141.
The first is a case
presentation of needlestick transmission of hepatitis C with a
review of some aspects of transmission and treatment. For the
purposes of this abstract data on transmission rates from a review
(search strategy not given) of hepatitis C transmission studies is
The second study is a
report of hepatitis C transmission in 14 workers with needlestick
injuries in which the source patients were positive for both the
hepatitis C antibody and RNA.
The authors of the first
paper found five studies documenting the transmission of hepatitis C
to healthcare workers. Two were from Japan, and one each from the
United States, Spain and Kuwait. The additional study was in Taiwan.
In all there were 329
exposed persons, and the overall transmission rate was 4.3%. The
variability in studies, with transmission rates between 0% and 10%.
There are differences between the studies include determination
of transmission (RNA or antibody measurements, completeness of
follow up, and whether all source patients were hepatitis C
positive, or the nature of the injury.
There is not as much
information as we would like to be sure of the rate of
transmission of hepatitis C. For the moment, a rate of 5% would
seem to be a sensible estimate.
This is a valuable paper that
is worth reading for those with a professional interest in
needlestick injuries. It includes a brief review of studies of
interferon treatment of hepatitis C and guidelines for
management of exposure to hepatitis C.