ACCIDENTAL TRANSMISSION OF HCV AND TREATMENT WITH INTERFERON

Accidental transmission of contagious pathogens, especially hepatitis C virus (HCV), by needlestick or other means as an occupational hazard for medical staff is of concern. We retrospectively analysed cases of work-related accidental injury with pathogens such as hepatitis B vir us (HBV), HCV, syphilis and human immunodeficiency virus (HIV) reporte d to the centres for disease control at 15 hospitals (total 5776 beds) in the Gunma prefecture, Japan, from December 1990 to August 1993 (24 .7 months). There were 416 such cases (16.8 cases/month), with an inci dence of 0.2-3.5 accidents per month per hospital. Such accidents occu rred in 297 (71.2%) nurses, 98 (23.5%) medical doctors, 13 (3%) labora tory technicians, four (1.0%) hospital maintenance workers, one (0.2%) assistant nurse, one secretary and two others. There were 323 (77.6%) injuries caused by needlestick, 42 (10.1%) from suture needles or sur gical knife cuts, 17 (4.1%) from blood splatters from patients into th e eyes or mouth, 10 (2.4%) from contact with injured skin and 24 (5.8% ) simple skin contacts. Of the pathogens, 60.3% were HCV, 22.6% HBV, 5 .8% syphilis, 0.7% HIV and 10.6% were of unknown origin. Four cases (1 .6%) of HCV infection were found and treated with one or two courses o f interferon therapy, and HCV was subsequently cleared. All four patie nts were cured with interferon therapy. None of the HBV-injured cases resulted in infection, possibly because of prophylaxis with HE immunog lobulin and HE vaccine. No HIV or syphilis infection was contracted. I n summary, chronic HCV infection acquired as an occupational hazard ca n be cured by appropriate treatment, such as with interferon, after ea rly detection of the infection.