Hepatitis C

Abstract

Readers of Adrian Di Bisceglie's seminar1Di Bisceglie AM Hepatitis C Lancet. 1998; 351: 351-355Summary Full Text Full Text PDF PubMed Scopus (375) Google Scholar on hepatitis C might be falsely reassured by the suggestion that iatrogenic transmission of HCV results only from the use of non-disposable needles (for example, in Egypt) or from traditional healing practices.Although Di Bisceglie mentions one report of HCV transmission from an infected surgeon, he makes no mention of the thousands of haemodialysed patients who become infected with HCV every year. In the era of virtually safe transfusions, it is troubling that annual rates of HCV seroconversion frequently exceed 3% (up to 15%) in patients who undergo haemodialysis.2Pereira BJG Levey AS Hepatitis C virus infection in dialysis and renal transplantation.Kidney Int. 1997; 51: 981-999Crossref PubMed Scopus (358) Google Scholar Nosocomial transmission—unequivocally shown by molecular virology—results mainly from poor hand hygiene by staff members and the sharing of objects between patients.3Jadoul M Transmission routes of HCV infection in dialysis.Nephrol Dial Transplant. 1996; 11: 36-38Crossref PubMed Scopus (53) Google Scholar Fortunately, careful adoption of universal precautions, as advocated by the Centers for Disease Control and Prevention (Atlanta, USA) should prevent HCV transmission as shown by a zero frequency of HCV seroconversion in the past 18 months of a large prospective study in patients undergoing haemodialysis.4Jadoul M, Cornu C, van Ypersele de Strihou C, and the UCL Collaborative Group. Universal precautions prevent hepatitis C virus transmission: a 54-month follow-up of the Belgian multicenter study. Kidney Int (in press).Google ScholarNosocomial transmission has also been reported in other hospital settings, such as haematology wards and even, more recently, during colonoscopy.5Bronowicki JP Venard V Botte C et al.Patient-to-patient transmission of hepatitis C virus during colonoscopy.N Engl J Med. 1997; 337: 237-240Crossref PubMed Scopus (401) Google Scholar The prevention of nosocomial transmission of all bloodborne pathogens including HCV remains a major challenge for all health-care workers. Readers of Adrian Di Bisceglie's seminar1Di Bisceglie AM Hepatitis C Lancet. 1998; 351: 351-355Summary Full Text Full Text PDF PubMed Scopus (375) Google Scholar on hepatitis C might be falsely reassured by the suggestion that iatrogenic transmission of HCV results only from the use of non-disposable needles (for example, in Egypt) or from traditional healing practices. Although Di Bisceglie mentions one report of HCV transmission from an infected surgeon, he makes no mention of the thousands of haemodialysed patients who become infected with HCV every year. In the era of virtually safe transfusions, it is troubling that annual rates of HCV seroconversion frequently exceed 3% (up to 15%) in patients who undergo haemodialysis.2Pereira BJG Levey AS Hepatitis C virus infection in dialysis and renal transplantation.Kidney Int. 1997; 51: 981-999Crossref PubMed Scopus (358) Google Scholar Nosocomial transmission—unequivocally shown by molecular virology—results mainly from poor hand hygiene by staff members and the sharing of objects between patients.3Jadoul M Transmission routes of HCV infection in dialysis.Nephrol Dial Transplant. 1996; 11: 36-38Crossref PubMed Scopus (53) Google Scholar Fortunately, careful adoption of universal precautions, as advocated by the Centers for Disease Control and Prevention (Atlanta, USA) should prevent HCV transmission as shown by a zero frequency of HCV seroconversion in the past 18 months of a large prospective study in patients undergoing haemodialysis.4Jadoul M, Cornu C, van Ypersele de Strihou C, and the UCL Collaborative Group. Universal precautions prevent hepatitis C virus transmission: a 54-month follow-up of the Belgian multicenter study. Kidney Int (in press).Google Scholar Nosocomial transmission has also been reported in other hospital settings, such as haematology wards and even, more recently, during colonoscopy.5Bronowicki JP Venard V Botte C et al.Patient-to-patient transmission of hepatitis C virus during colonoscopy.N Engl J Med. 1997; 337: 237-240Crossref PubMed Scopus (401) Google Scholar The prevention of nosocomial transmission of all bloodborne pathogens including HCV remains a major challenge for all health-care workers.