INCIDENCE OF NON-A, NON-B AND HCV POSITIVE HEPATITIS IN HEALTH-CARE WORKERS IN ITALY

In Italy, using figures from a surveillance system for acute viral hep atitis, the incidence rate of acute non-A, non-B hepatitis (NANBH) and hepatitis C virus (HCV) hepatitis cases was evaluated in healthcare w orkers (HCWs) and the general population of the same age over the peri od 1988-1994. The NANBH incidence among the general population decline d from 4.7/100 000 in 1988 to 2.1/100 000 in 1994; the corresponding f igures among HCWs were 12.3/100 000 (RR 2.62; CI 95%=1.66-4.15) in 198 8 and 4.3/100 000 (RR 2.05; CI 95%=1.13-3.77) in 1994. Since 1991, NAN BH cases have been tested for antibodies to HCV (anti-HCV). During the period 1991-1994 the proportion of NANBH cases tested for anti-HCV wa s 81% (38/47) in HCWs and 85% (1019/1193) in other NANBH cases. A simi lar proportion of NANBH cases in each group (74% and 70%) were shown t o be due to HCV. The incidence rate of HCV positive cases among the ge neral population was 1.3/100 000 in 1991 and 1.8/100 000 in 1994; the corresponding figures among HCWs were 3.7/100 000 (RR 2.85; CI 95%=1.4 2-5.92) in 1991 and 3.1/100 000 (RR 1.72; CI 95%=0.88-3.59) in 1994. T he proportion of cases with jaundice was 56.2% in HCWs and 63.7% in th e general population. Needlestick injury without major risk factors su ch as blood transfusion, intravenous drug use or surgical intervention was reported by 12.0% of HCWs and by 0.1% of the general population. Lack of any risk factor was reported by 40.2% of HCWs. These findings strongly suggest that in Italy healthcare workers are at greater risk than the general population of acquiring NANBH, as well as HCV.