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Needlestick and hepatitis C transmission

 

Clinical bottom line

A transmission rate of 5% would seem to be a sensible estimate for hepatitis C.


References

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.

Studies

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 abstracted.

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.

Results

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%, is shown in Figure 1.

Figure 1: Hepatitis C transmission studies


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.

Comment

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.