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Frequent transient hepatitis C viremia without seroconversion among healthcare workers in Cairo, Egypt.

Munier A, Marzouk D, Abravanel F, El-Daly M, Taylor S, Mamdouh R, Eldin WS, El-Arab HE, Sos DG, Momen M, Okasha O, Le Fouler L, El-Hosini M, Izopet J, Rafik M, Albert M, Abdel-Hamid M, Mohamed MK, Delarocque-Astagneau E, Fontanet A - PLoS ONE (2013)

Bottom Line: None of the workers presented seroconversion or elevation of ALT.HCWs of a general University hospital in Cairo were exposed to a highly viremic patient population.These findings call for further investigation of potential immune protection against HCV persistence in this high risk group.

View Article: PubMed Central - PubMed

Affiliation: Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France. aline.munier@pasteur.fr

ABSTRACT

Backgrounds: With 10% of the general population aged 15-59 years chronically infected with hepatitis C virus (HCV), Egypt is the country with the highest HCV prevalence worldwide. Healthcare workers (HCWs) are therefore at particularly high risk of HCV infection. Our aim was to study HCV infection risk after occupational blood exposure among HCWs in Cairo.

Methodology/principal findings: The study was conducted in 2008-2010 at Ain Shams University Hospital, Cairo. HCWs reporting an occupational blood exposure at screening, having neither anti-HCV antibodies (anti-HCV) nor HCV RNA, and exposed to a HCV RNA positive patient, were enrolled in a 6-month prospective cohort with follow-up visits at weeks 2, 4, 8, 12 and 24. During follow-up, anti-HCV, HCV RNA and ALT were tested. Among 597 HCWs who reported a blood exposure, anti-HCV prevalence at screening was 7.2%, not different from that of the general population of Cairo after age-standardization (11.6% and 10.4% respectively, p = 0.62). The proportion of HCV viremia among index patients was 37%. Of 73 HCWs exposed to HCV RNA from index patients, nine (12.3%; 95%CI, 5.8-22.1%) presented transient viremia, the majority of which occurred within the first two weeks after exposure. None of the workers presented seroconversion or elevation of ALT.

Conclusions/significance: HCWs of a general University hospital in Cairo were exposed to a highly viremic patient population. They experienced frequent occupational blood exposures, particularly in early stages of training. These exposures resulted in transient viremic episodes without established infection. These findings call for further investigation of potential immune protection against HCV persistence in this high risk group.

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Related in: MedlinePlus

Study flowchart, Ain shams University Hospital, Cairo.HCW: healthcare worker; OBE: occupational blood exposure, IP: index patient; HCV-Ab: Hepatitis C virus antibody.
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pone-0057835-g001: Study flowchart, Ain shams University Hospital, Cairo.HCW: healthcare worker; OBE: occupational blood exposure, IP: index patient; HCV-Ab: Hepatitis C virus antibody.

Mentions: Overall, 597 HCWs reported an OBE from August 2008 to September 2010 (Figure 1). Among these HCWs, 294 (49.3%) were physicians-in-training (i.e. in first year of residency) (Table 1). There were 219 HCWs (36.7%) in the internal medicine department and 146 (24.4%) in the surgery department. Their median age was 24 years [Q25–75, 24–28]. The median delay between exposure and reporting was one day [Q25–75, 0–2]. A peak of OBE was observed for physicians-in-training between March and May (Figure 2). This three-month period represented 50% of all OBE for physicians in training versus 30% of all OBE for other staff (p<0.001).


Frequent transient hepatitis C viremia without seroconversion among healthcare workers in Cairo, Egypt.

Munier A, Marzouk D, Abravanel F, El-Daly M, Taylor S, Mamdouh R, Eldin WS, El-Arab HE, Sos DG, Momen M, Okasha O, Le Fouler L, El-Hosini M, Izopet J, Rafik M, Albert M, Abdel-Hamid M, Mohamed MK, Delarocque-Astagneau E, Fontanet A - PLoS ONE (2013)

Study flowchart, Ain shams University Hospital, Cairo.HCW: healthcare worker; OBE: occupational blood exposure, IP: index patient; HCV-Ab: Hepatitis C virus antibody.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585182&req=5

pone-0057835-g001: Study flowchart, Ain shams University Hospital, Cairo.HCW: healthcare worker; OBE: occupational blood exposure, IP: index patient; HCV-Ab: Hepatitis C virus antibody.
Mentions: Overall, 597 HCWs reported an OBE from August 2008 to September 2010 (Figure 1). Among these HCWs, 294 (49.3%) were physicians-in-training (i.e. in first year of residency) (Table 1). There were 219 HCWs (36.7%) in the internal medicine department and 146 (24.4%) in the surgery department. Their median age was 24 years [Q25–75, 24–28]. The median delay between exposure and reporting was one day [Q25–75, 0–2]. A peak of OBE was observed for physicians-in-training between March and May (Figure 2). This three-month period represented 50% of all OBE for physicians in training versus 30% of all OBE for other staff (p<0.001).

Bottom Line: None of the workers presented seroconversion or elevation of ALT.HCWs of a general University hospital in Cairo were exposed to a highly viremic patient population.These findings call for further investigation of potential immune protection against HCV persistence in this high risk group.

View Article: PubMed Central - PubMed

Affiliation: Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France. aline.munier@pasteur.fr

ABSTRACT

Backgrounds: With 10% of the general population aged 15-59 years chronically infected with hepatitis C virus (HCV), Egypt is the country with the highest HCV prevalence worldwide. Healthcare workers (HCWs) are therefore at particularly high risk of HCV infection. Our aim was to study HCV infection risk after occupational blood exposure among HCWs in Cairo.

Methodology/principal findings: The study was conducted in 2008-2010 at Ain Shams University Hospital, Cairo. HCWs reporting an occupational blood exposure at screening, having neither anti-HCV antibodies (anti-HCV) nor HCV RNA, and exposed to a HCV RNA positive patient, were enrolled in a 6-month prospective cohort with follow-up visits at weeks 2, 4, 8, 12 and 24. During follow-up, anti-HCV, HCV RNA and ALT were tested. Among 597 HCWs who reported a blood exposure, anti-HCV prevalence at screening was 7.2%, not different from that of the general population of Cairo after age-standardization (11.6% and 10.4% respectively, p = 0.62). The proportion of HCV viremia among index patients was 37%. Of 73 HCWs exposed to HCV RNA from index patients, nine (12.3%; 95%CI, 5.8-22.1%) presented transient viremia, the majority of which occurred within the first two weeks after exposure. None of the workers presented seroconversion or elevation of ALT.

Conclusions/significance: HCWs of a general University hospital in Cairo were exposed to a highly viremic patient population. They experienced frequent occupational blood exposures, particularly in early stages of training. These exposures resulted in transient viremic episodes without established infection. These findings call for further investigation of potential immune protection against HCV persistence in this high risk group.

Show MeSH
Related in: MedlinePlus