Williams Sian, Libotte Valerie, Ramsay Mary
Occupational Health and Safety Unit, Royal Free Hospital, London NW3 2QG, UK.
Occup Med (Lond). 2007 Dec;57(8):596-8. doi: 10.1093/occmed/kqm010. Epub 2007 Mar 26.
Accidental percutaneous exposure to blood containing hepatitis C virus (HCV) is reported by health care workers more frequently than exposure to human immunodeficiency and hepatitis B virus. The transmission rate following such an exposure is approximately 1.9%. Little is known about the attendance rate of such staff for follow-up testing following exposure to HCV.
To determine whether our follow-up programme for staff exposed to hepatitis C would allow the early detection and treatment of infected staff members.
We reviewed all staff exposures to hepatitis C reported to the occupational health department of a London teaching hospital over a 8-year period.
Of 105 exposures, 21% of staff attended for early (6 or 12 weeks) and late (26 weeks) post-exposure follow-up. Thirty-seven per cent attended early follow-up only and 1% attended late having not attended early follow-up. Forty per cent did not attend any follow-up appointments with us.
With the availability of effective treatment for early HCV infection, it is vital that occupational health departments encourage staff to attend at least for early follow-up. Access to HCV-RNA testing at this early stage should allow detection and early treatment of the small proportion who seroconvert.
医护人员报告的意外经皮接触含丙型肝炎病毒（HCV）血液的情况比接触人类免疫缺陷病毒和乙型肝炎病毒更为频繁。此类接触后的传播率约为1.9%。对于此类工作人员暴露于HCV后进行后续检测的出勤率知之甚少。
确定我们针对暴露于丙型肝炎的工作人员的随访计划是否能实现对受感染工作人员的早期检测和治疗。
我们回顾了一家伦敦教学医院职业健康部门在8年期间报告的所有工作人员暴露于丙型肝炎的情况。
在105次暴露中，21%的工作人员参加了暴露后早期（6周或12周）和晚期（26周）的随访。37%的人仅参加了早期随访，1%的人未参加早期随访而只参加了晚期随访。40%的人未与我们进行任何随访预约。
鉴于早期HCV感染有有效的治疗方法，职业健康部门鼓励工作人员至少参加早期随访至关重要。在这一早期阶段进行HCV-RNA检测应能检测出并早期治疗一小部分血清转化的人员。
