Contributors: Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology; Pasteur-Cnam Risques infectieux et émergents (PACRI); Institut Pasteur Paris (IP)-Conservatoire National des Arts et Métiers CNAM (CNAM)-Institut Pasteur Paris (IP)-Conservatoire National des Arts et Métiers CNAM (CNAM); Université Ain Shams; Centre de Physiopathologie Toulouse Purpan (CPTP); Université Toulouse III - Paul Sabatier (UT3); Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); National Hepatology & Tropical Medicine Research Institute; Menoufia University; National Liver Institute Menoufia, Egypt; Menoufia University Egypte -Menoufia University Egypte; Faculty of medicine; Immunobiologie des Cellules Dendritiques; Institut Pasteur Paris (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM); Minia University; This work was supported by the Agence nationale de recherches sur le Sida et les Hépatites virales,France, grant number ANRS 12171; We gratefully thank the healthcare workers who accepted to be part of the study. We are grateful to Dina Aly and Ghada Wassef, Faculty of Medicine, Ain Shams University, Cairo, for their help in monitoring follow-up of HCWs; to Melissa Laird, Institut Pasteur/INSERM, for her collaboration in the immunology team, to all participating prick injury clinics; to Prof. Ghada Ismail, Head of Central Unit for Infection Control in Ain Shams and her staff; to Prof. Wagida Anwar, Head of Department of Community, Environmental and Occupational Medicine at the Faculty of Medicine, Ain Shams University, Cairo; and to Prof. Ahmed Nassar, Dean of Ain Shams University Hospital, for allowing the conduct of the study in Ain Shams University hospitals.
نبذة مختصرة : International audience ; BACKGROUND: With 10% of the general population aged 15-59 years chronically infected with hepatitis C virus (HCV), Egypt is the country with the highest HCV prevalence worldwide. Healthcare workers (HCWs) are therefore at particularly high risk of HCV infection. Our aim was to study HCV infection risk after occupational blood exposure among HCWs in Cairo.METHODOLOGY/PRINCIPAL FINDINGS:The study was conducted in 2008-2010 at Ain Shams University Hospital, Cairo. HCWs reporting an occupational blood exposure at screening, having neither anti-HCV antibodies (anti-HCV) nor HCV RNA, and exposed to a HCV RNA positive patient, were enrolled in a 6-month prospective cohort with follow-up visits at weeks 2, 4, 8, 12 and 24. During follow-up, anti-HCV, HCV RNA and ALT were tested. Among 597 HCWs who reported a blood exposure, anti-HCV prevalence at screening was 7.2%, not different from that of the general population of Cairo after age-standardization (11.6% and 10.4% respectively, p = 0.62). The proportion of HCV viremia among index patients was 37%. Of 73 HCWs exposed to HCV RNA from index patients, nine (12.3%; 95%CI, 5.8-22.1%) presented transient viremia, the majority of which occurred within the first two weeks after exposure. None of the workers presented seroconversion or elevation of ALT.CONCLUSIONS/SIGNIFICANCE:HCWs of a general University hospital in Cairo were exposed to a highly viremic patient population. They experienced frequent occupational blood exposures, particularly in early stages of training. These exposures resulted in transient viremic episodes without established infection. These findings call for further investigation of potential immune protection against HCV persistence in this high risk group.
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