Risk factors for hepatitis C virus transmission to health care workers after occupational exposure: A European case-control study

被引：114

作者：

Yazdanpanah, Y

De Carli, G

Migueres, B

Lot, F

Campins, M

Colombo, C

Thomas, T

Deuffic-Burban, S

Prevot, MH

Domart, M

Tarantola, A

Abiteboul, D

Deny, P

Pol, S

Desenclos, JC

Puro, V

Bouvet, E

机构：

[1] Ctr Hosp Tourcoing, Serv Univ Maladies Infect & Voyageur, F-59208 Tourcoing, France

[2] Fac Med Lille, Equipe Accueil 2694, Lille, France

[3] CNRS, Lab Rech Econ & Sociales, URA 362, Lille, France

[4] Hop Bichat Claude Bernard, Grp Etude Ris Exposit Sang, Paris, France

[5] Hop Bichat Claude Bernard, Serv Med Travail, Paris, France

[6] Hop Bichat Claude Bernard, Serv Malad Infect & Trop, Paris, France

[7] Hop Necker Enfants Malad, Hepatol Unit, Paris, France

[8] Hop Necker Enfants Malad, Inst Natl Sante Rech Med, U370, Paris, France

[9] Hop Raymond Poincare, Serv Med Travail, Garches, France

[10] Hop Avicenne, Lab Bacteriol Virol, F-93009 Bobigny, France

[11] Ist Nazl Malattie Infett L Spallanzani, Rome, Italy

[12] Hosp Gen Valle Hebron, Serv Med Prevent & Epidemiol, Barcelona, Spain

[13] Univ Zurich Hosp, Div Infect Dis, Referenzzentrum Blutubertragbare Infekt Gesundhei, CH-8091 Zurich, Switzerland

[14] HIV & STI Div Communicable Dis Surveillance Ctr, London, England

来源：

CLINICAL INFECTIOUS DISEASES | 2005年 / 41卷 / 10期

关键词：

D O I：

10.1086/497131

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Additional studies are required to identify risk factors for hepatitis C virus (HCV) transmission to health care workers after occupational exposure to HCV. Methods. We conducted a matched case-control study in 5 European countries from 1 January 1991 through 31 December 2002. Case patients were health care workers who experienced seroconversion after percutaneous or mucocutaneous exposure to HCV. Control subjects were HCV-exposed health care workers who did not experience seroconversion and were matched with case patients for center and period of exposure. Results. Sixty case patients and 204 control subjects were included in the study. All case patients were exposed to HCV-infected fluids through percutaneous injuries. The 37 case patients for whom information was available were exposed to viremic source patients. As risk factors for HCV infection, multivariate analysis identified needle placement in a source patient's vein or artery (odds ratio [OR], 100.1;95% confidence interval [CI], 7.3-1365.7), deep injury (OR, 155.2; 95% CI,7.1-3417.2), and sex of the health care worker (OR for male vs. female, 3.1; 95% CI, 1.0-10.0). Source patient HCV load was not introduced in the multivariate model. In unmatched univariate analysis, the risk of HCV transmission increased 11-fold for health care workers exposed to source patients with a viral load > 6 log(10) copies/mL ( 95% CI, 1.1-114.1), compared with exposures to source patients with a viral load <= 4 log(10) copies/ mL. Conclusion. In this study, HCV occupational transmission was found to occur after percutaneous exposures. The risk of HCV transmission after percutaneous exposure increased with deep injuries and procedures involving hollow-bore needle placement in the source patient's vein or artery. These results highlight the need for widespread adoption of needlestick-prevention devices in health care settings, together with other preventive measures.

引用

页码：1423 / 1430

页数：8

共 52 条

[1]

Abiteboul D, 2002, B EPIDEMIOL HEBD, V51, P256

[2]

Arai Y, 1996, LIVER, V16, P331

[3] Perinatal hepatitis C virus transmission - Role of human immunodeficiency virus infection and injection drug use [J].