R S Ross1, S Viazov, M Roggendorf. 1. Essen University Hospital, National Reference Centre for Hepatitis C, Essen, Germany. stefan.ross@uni-essen.de
Abstract
CONTEXT: Concern is increasing in both the medical community and among the general public about the possible transmission of hepatitis C virus (HCV) from infected health care workers to their patients. Until now, no reliable estimates for the risk of such transmission exist. OBJECTIVE: To estimate the probability of HCV transmission from a surgeon to a susceptible patient during invasive procedures. DESIGN: A model consisting of 4 probabilities was used: (A) the probability that the surgeon is infected with HCV, (B) the probability that the surgeon might contract percutaneous injuries, (C) the probability that an HCV-contaminated instrument will recontact the wound, and (D) the probability of HCV transmission after exposure. Values for the calculations were taken from published studies. RESULTS: When the surgeon's HCV status is unknown, the risk of HCV transmission during a single operation is 0.00018% +/- 0.00002% (mean +/- SD). If the surgeon is HCV RNA positive, this risk equals 0.014% +/- 0.002%. The likelihoods of transmission in at least 1 of 5000 invasive procedures performed by a surgeon during 10 years are 0.9% +/- 0.1% (HCV status unknown) and 50.3% +/- 4.8% (HCV RNA positive), respectively. CONCLUSIONS: The calculated risks for HCV transmission from a surgeon to a susceptible patient during a single invasive procedure are comparable to the chance of acquiring HCV by receiving a blood transfusion. These figures could provide a basis for further discussions on this controversial subject and might also be relevant for future recommendations on the management of HCV-infected health care workers.
CONTEXT: Concern is increasing in both the medical community and among the general public about the possible transmission of hepatitis C virus (HCV) from infected health care workers to their patients. Until now, no reliable estimates for the risk of such transmission exist. OBJECTIVE: To estimate the probability of HCV transmission from a surgeon to a susceptible patient during invasive procedures. DESIGN: A model consisting of 4 probabilities was used: (A) the probability that the surgeon is infected with HCV, (B) the probability that the surgeon might contract percutaneous injuries, (C) the probability that an HCV-contaminated instrument will recontact the wound, and (D) the probability of HCV transmission after exposure. Values for the calculations were taken from published studies. RESULTS: When the surgeon's HCV status is unknown, the risk of HCV transmission during a single operation is 0.00018% +/- 0.00002% (mean +/- SD). If the surgeon is HCV RNA positive, this risk equals 0.014% +/- 0.002%. The likelihoods of transmission in at least 1 of 5000 invasive procedures performed by a surgeon during 10 years are 0.9% +/- 0.1% (HCV status unknown) and 50.3% +/- 4.8% (HCV RNA positive), respectively. CONCLUSIONS: The calculated risks for HCV transmission from a surgeon to a susceptible patient during a single invasive procedure are comparable to the chance of acquiring HCV by receiving a blood transfusion. These figures could provide a basis for further discussions on this controversial subject and might also be relevant for future recommendations on the management of HCV-infected health care workers.
Authors: Meenakshi Dawar; Tammy L Stuart; Lamont E Sweet; Anne M Neatby; Lewis P Abbott; Anton P Andonov; Tom Wong; Robert Gervais; Rob Stirling Journal: Can J Infect Dis Med Microbiol Date: 2010 Impact factor: 2.471
Authors: Steffanie A Strathdee; Jaime Arredondo; Teresita Rocha; Daniela Abramovitz; Maria Luisa Rolon; Efrain Patiño Mandujano; Maria Gudelia Rangel; Horcasitas Omar Olivarria; Tommi Gaines; Thomas L Patterson; Leo Beletsky Journal: BMJ Open Date: 2015-08-10 Impact factor: 2.692