Occupationally acquired hepatitis C infection

The hepatitis C virus (HCV) is a common pathogen which is readily transmitt ed by contact with blood or body fluids. Unusually for an RNA virus, it lea ds to a chronic carrier state in 85% of infected individuals with the possi ble consequence of chronic hepatitis, cirrhosis and primary hepatocellular carcinoma. Healthcare workers are at potential risk of HCV infection throug h accidental percutaneous injury with needlestick or sharps and mucous memb rane splattering with blood. No vaccine is available to prevent infection. HCV is common in the community and most carriers are unaware of their infec tion. Universal precautions are recommended for contact with all patients t o diminish the risk of transmission of blood-borne viruses. Needlestick inj ury still occurs too frequently during operative procedures, but improvemen ts in instruments and changes in techniques are helping to reduce this prob lem. Surveys of healthcare workers have shown an increase in HCV infection rates, but fortunately the carrier rate is low. There is no appropriate imm une globulin preparation or antiviral drug that can be given immediately fo llowing a needlestick injury from an infectious source. If anti-HCV serocon version occurs after 3-6 months then antiviral therapy has a high probabili ty of clearing the infection. Therefore, healthcare workers are strongly en couraged to report any injuries which may have exposed them to the risk of HCV infection. (C) 2000 Lippincott Williams & Wilkins.