Hepatitis C virus contamination of endoscopes and biopsy forceps

Background - Procedures such as digestive endoscopy may explain some unclea r contaminations by HCV. Aims - The aims of this study were to defect HCV g enome on endoscopes and biopsy-forceps used in patients with known chronic HCV infection and to determine its presence in their gastric juice and sali va. Methods - A gastroscopy with antral biopsies was performed in 48 patients w ith non-treated replicative chronic hepatitis C. Samples were obtained afte r pushing 10 mL of sterile water through the biopsy-suction channel and aft er immersing the brush used to clean this channel. The biopsy-forceps were also immersed and their tips brushed in T0 mL of sterile water. This sampli ng technique was repeated three times: immediately after the endoscopic pro cedure (T0), after washing with a detergent (T1) and after immersion for 20 minutes in a 2% glutaraldehyde solution (T2). The HCV genome was detected by polymerase chain reaction (PCR, Amplico(R) - Roche Diagnostics Systems). For the last 15 patients, samples of gastric juice and saliva were obtaine d before antral biopsies and used to detect HCV genome. Results - HCV genome was detected in the biopsy-suction channel in 13 cases (27%) at T0 and in one case (2%) at T1. It was undetectable after completi on of the disinfection procedure (T2). Three biopsy-forceps (6%) were PCR p ositive immediately after the endoscopy but none at T1 and T2. HCV genome w ets found in the gastric juice in three cases. In all of them, them, it was also found at T0 in the biopsy-suction channel but not on the biopsy-force ps. When saliva contained HCV genome (4 cases), it was present in the biops y-suction channel in only one case. In this case, the gastric juice was als o PCR positive. Conclusions - HCV genome is defected in 27% of cases in the biopsy-suction channel after an endoscopic procedure performed on patients with chronic HC V infection. The biopsy-forceps are PCR positive in 6% of cases. The infect ed gastric juice may play a role in the contamination of the endoscopes. Th e complete disinfection procedure seems effective to eliminate HCV.