FROM THE AMERICAN JOURNAL OF INFECTION CONTROL
An analysis of 13 years of accidental occupational exposures to hepatitis C virus–contaminated fluids or instruments has revealed a seroconversion rate of just 0.1%, significantly lower than that reported in the literature.
That’s according to an longitudinal analysis of data from a prospectively maintained database of 1,361 occupational injuries involving a hepatitis C virus–positive source that occurred between 2002 and 2015 conducted by Francesco M. Egro, MD , and his colleagues from the University of Pittsburgh Medical Center.
The two incidents of seroconversion occurred in patients who were exposed to blood from a hepatitis C virus (HCV)-positive patient via percutaneous injuries to the thumb from a hollow-bore needle, representing an overall seroconversion rate of 0.1%. In both cases, the source patients whose blood was involved were not coinfected with hepatitis B virus or HIV (Am J Infect Control. 2017 Apr 24. doi: 10.1016/j.ajic.2017.03.011 ). Researchers also conducted a review of literature on needlestick injuries and occupational exposure to HCV-infected blood and fluids, and from this calculated an overall seroconversion rate average of 0.7%, with an average rate of 0.8% for percutaneous exposures. This did not include mucomembranous exposure as there were not enough data.
In the study, 65% of the exposures were caused by percutaneous injuries and 34% were caused by mucocutaneous injuries, and the remaining 1% were uncertain.
The hand was the most common site of injury (63%), followed by the face and neck (28%) and the arm, foot, leg, or trunk (4%). There was no record of the anatomical location of the injury in 5% of cases.
In nearly three-quarters of cases, blood was the source of exposure, while blood-containing saliva accounted for 3% of cases. The remaining 24% of cases were linked to other fluids such as peritoneal fluid, tracheal secretions, amniotic fluid, bloody irrigation fluid, and blood-containing feces.
“The risk of transmission after exposure to HCV-positive patients’ fluids or tissues other than blood is expected to be low, but has not been formally quantified,” the authors wrote. “Although there have been reports of HCV seroconversion after human bites and after punching a HCV-positive individual in the teeth, percutaneous exposures to the blood of a HCV-positive source remain the most common cause of occupational HCV transmission.”
While the rate of seroconversion was low, the authors encouraged prompt reporting, testing, and follow-up of exposed individuals.
No conflicts of interest were declared.
On Twitter @IDPractitioner
