Universal treatment success among healthcare workers diagnosed with occupationally acquired acute hepatitis C

Exploring the psychological effects of sharps injuries sustained by healthcare workers

Much of the research into sharps injuries sustained by healthcare workers focuses on prevalence and incidence and to a lesser extent the financial implications of such injuries. An under-researched area is the psychological effects of such injuries. This article reports the findings of a narrative literature review that aimed to synthesise the evidence on this subject. Electronic databases and the grey literature were searched with no date limits set and 27 articles were included in the review. Findings suggested that healthcare workers may experience a range of psychological issues following a sharps injury, including post-traumatic stress disorder, anxiety and depression. There was also evidence to suggest that the necessary psychological follow-up care is often inadequate, so improvements are required in this area. Further research is necessary to enhance understanding of the psychological effects of sharps injuries on healthcare workers and to ensure they receive appropriate support.

HCV avidity as a tool for detection of recent HCV infection: Sensitivity depends on HCV genotype

Accurate detection of incident hepatitis C virus (HCV) infection is required to target and evaluate public health interventions, but acute infection is largely asymptomatic and difficult to detect using traditional methods. Our aim was to evaluate a previously developed HCV avidity assay to distinguish acute from chronic HCV infection. Plasma samples collected from recent seroconversion subjects in two large Australian cohorts were tested using the avidity assay, and the avidity index (AI) was calculated. Demographic and clinical characteristics of patients with low/high AI were compared via logistic regression. Sensitivity and specificity of the assay for recent infection and the mean duration of recent infection (MDRI) were estimated stratified by HCV genotype. Avidity was assessed in 567 samples (from 215 participants), including 304 with viraemia (defined as ≥250 IU/mL). An inverse relationship between AI and infection duration was found in viraemic samples only. The adjusted odds of a low AI (<30%) decreased with infection duration (odds ratio [OR] per week of 0.93; 95% CI:0.89-0.97), and were lower for G1 compared with G3 samples (OR = 0.14; 95% CI:0.05-0.39). Defining recent infection as <26 weeks, sensitivity (at AI cut-off of 20%) was estimated at 48% (95% CI:39-56%), 36% (95% CI:20-52%), and 65% (95% CI:54-75%) and MDRI was 116, 83, and 152 days for all genotypes, G1, and G3, respectively. Specificity (≥52 weeks infection duration, all genotypes) was 96% (95% CI:90-98%). HCV avidity testing has utility for detecting recent HCV infection in patients, and for assessing progress in reaching incidence targets for eliminating transmission, but variation in assay performance across genotype should be recognized.

Use of genome sequencing to identify hepatitis C virus transmission in a renal healthcare setting

BACKGROUND

Hepatitis C virus (HCV) infection is a major health burden worldwide. A patient with no history of HCV infection while on a renal unit was found to seroconvert to HCV.

AIM

To report the use of sequencing to postulate how transmission of HCV occurred in a healthcare setting, and how this guided our outbreak investigation.

FINDINGS

Based on infection control inspections the transmission event was surmised to be due to ward environmental contamination with blood and subsequent inoculation from intravenous interventions on the patient acquiring HCV. We discuss the interventions put in place in response to the outbreak investigation findings.

CONCLUSION

Sequencing of healthcare-acquired HCV infections should be undertaken as routine practice in outbreak investigations.

Human immunodeficiency virus, hepatitis B virus and hepatitis C virus seroprevalence in critically ill emergency department patients at a Trauma Care Centre, India

INTRODUCTION

Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are the most common occupationally acquired infections amongst the healthcare workers (HCWs) with critically ill patients attending the emergency department being the most common source of occupationally acquired infections. Therefore, the present study was conducted at a 165 bedded level-1 trauma centre of India to ascertain the seroprevalence rate of HIV, HBV and HCV; and thus the risk associated with the occupational exposure in a busy emergency setting of the developing world.

METHODOLOGY

A retrospective, 7 years study (2007-2013) was carried out at the JPNA Trauma Centre of the 2,500 bedded All India Institute of Medical Sciences, New Delhi. Records of all patients whose serum samples were sent to the laboratory for viral markers testing were obtained and those falling in the red area were included.

RESULTS

A total of 11,630 patients were received in the red area; and samples from 7,650 patients were sent for testing. Seropositivity of HIV, HBV and HCV in these samples was 0.28%, 3.4% and 0.9% respectively. The number of samples received was lesser than the total number of patients received in the red area.

CONCLUSION

Adopting Standard Precautions (SP) can be used as an easy method to decrease the risk of occupationally acquired infections.