TRANSMISSION OF VIRUS-C DURING ENDOSCOPIC EXAMINATION

Objectives. - In 30 to 50 % of cases, the route of transmission of vin ts C remains unknown. The aim of this study was to investigate the eff ectiveness of manual cleaning and disinfection procedures after endosc opic examinations in highly infected patients. Methods. - In 39 patien ts with chronic hepatitis C and a high level of replication, a gastros copy with biopsy was performed with a fully submersible endoscope. Cle aning and disinfection were carried out with the following protocol: c leaning with detergent solution (Sekulyse(R), rinsing, 3 to 5 min imme rsion into a glutaraldehyde disinfectant solution (Sekucid(R)) and fin al rinsing. One hundred mt of sterile water was flushed through the bi opsy channel immediately after removal of the endoscope (T1), after cl eaning (T2), and after final disinfection (T3). These 100 mL. were col lected in aliquots for viral and bacterial screening. Virus C particle s were searched for in the effluent of the biopsy channel using two me thods of polymerase chain reaction. Results. - Virus C particles were found in 2 of 39 patients in T1 aliquots collected before washing. Rou tine cleaning with a detergent eliminated all viral particles, as test s were negative at T2 and T3. The usual bacteria (Pseudomonas, Strepto coccus, Neisseria...) were detected at T1 and had disappeared after to tal disinfection at T3. Conclusion. - Virus C hepatitis could be trans mitted during endoscopic examination, but cleaning and disinfection pr ocedures effectively eliminated all viral particles.