HEPATITIS-C VIRUS-INFECTION IN HEALTH-CARE WORKERS - RISK OF EXPOSUREAND INFECTION

OBJECTIVES: To determine the incidence of hepatitis C virus (HCV) infe ction among healthcare workers (HCWs) at a university hospital, the pr oportion of HCWs having non-A, non-B hepatitis (NANBH) who were anti-H CV positive, and the rate of HCV transmission following a HCV-positive needlestick injury. DESIGN: Longitudinal analysis of a dynamic (cohor t) population. MEASUREMENTS: From 1980 through 1989, HCWs who had clin ical NANBH were identified, and from 1987 through 1989, HCWs who repor ted a blood or body fluid exposure and the patients who were the sourc e of the exposure were screened for antibodies to HCV. SETTING: A 732- bed, university hospital and outpatient clinics. RESULTS: Over the 10- year period, six cases of occupationally acquired NANBH were observed, for an incidence of 21 cases per 100,000 HCWs per year (standardized incidence ratio, 2.96; 95% confidence interval [CI95], 1.83 to 4.36). Four of the six cases were confirmed to be HCV infection. From 1987 th rough 1989, 176 (12.7%) of 1,387 patients who were the source of an ex posure were anti-HCV positive. Exposures that occurred in the emergenc y department were more likely to be anti-HCV positive than were exposu res from all other locations (relative risk [RR] = 1.7; P = 0.009). Of HCWs who had an HCV-positive needlestick injury and whose serum had b een tested for anti-HCV at least 5 months after the exposure, 3 (6.0%) of 50 seroconverted. From 1987 through 1989, the incidence of HCV inf ection among HCWs was 54 cases per 100,000 HCWs per year. CONCLUSION: The incidence of clinical NANBH among HCWs in this study is approximat ely three times higher than that of non-HCWs. HCWs are at significant risk for exposure to and acquisition of HCV (Infect Control Hosp Epide miol 1994; 15:745-750).