Zuckerman J, Clewley G, Griffiths P, Cockcroft A
Occupational Health Unit, Royal Free NHS Trust, London, UK.
Lancet. 1994 Jun 25;343(8913):1618-20. doi: 10.1016/s0140-6736(94)93064-3.
Health-care workers are known to be at risk from occupational transmission of blood-borne viruses, including hepatitis C. There may be serious implications following infection with hepatitis C including possible transmission to patients. We determined the prevalence of hepatitis C virus (HCV) antibodies among health-care workers at risk of occupational contact with blood and body fluids and among source patients in reported blood-exposure incidents. Anonymised stored blood samples from health-care workers immunised against hepatitis B virus since 1991 (n = 1053) and blood samples from source patients in needlestick injuries (retrospective and prospective) since 1989 (n = 373) were analysed. 3 (0.28%) of the serum samples from health-care workers were found to be anti-HCV-positive. 17 (8.5%) of 200 source patients tested retrospectively between January 1989 and January 1992, and 24 (13.9%) of 173 source patients tested prospectively between January 1992 and June 1993 were anti-HCV-positive. During the second period, 15 (10.6%) of 142 source patients tested for human immunodeficiency virus (HIV) were positive and 7 (3.8%) of 184 source patients tested for hepatitis B surface antigen were positive. 6 of 24 (25%) HCV-infected patients were diagnosed only after the incident; for hepatitis B, 2 (33%) of patients were diagnosed after the incident, and for HIV all patients were previously diagnosed. The seroprevalence of HCV among these health-care workers is no higher than that reported in blood donors.(ABSTRACT TRUNCATED AT 250 WORDS)
医护人员已知面临通过职业途径感染包括丙型肝炎在内的血源性病毒的风险。感染丙型肝炎可能会产生严重后果,包括可能传染给患者。我们确定了有职业接触血液和体液风险的医护人员以及报告的血液暴露事件中源患者的丙型肝炎病毒(HCV)抗体流行率。分析了自1991年以来接种过乙肝疫苗的医护人员的匿名储存血样(n = 1053)以及自1989年以来针刺伤源患者的血样(回顾性和前瞻性,n = 373)。发现医护人员血清样本中有3例(0.28%)抗-HCV呈阳性。在1989年1月至1992年1月间进行回顾性检测的200例源患者中,有17例(8.5%)抗-HCV呈阳性,在1992年1月至1993年6月间进行前瞻性检测的173例源患者中,有24例(13.9%)抗-HCV呈阳性。在第二个时期,检测人类免疫缺陷病毒(HIV)的142例源患者中有15例(10.6%)呈阳性,检测乙肝表面抗原的184例源患者中有7例(3.8%)呈阳性。24例HCV感染患者中有6例(25%)在事件发生后才被诊断出来;对于乙肝,2例(33%)患者在事件发生后被诊断出来,而对于HIV,所有患者之前均已被诊断。这些医护人员中HCV的血清流行率不高于献血者报告的水平。(摘要截短于250字)