Hepatitis C: and miles to go before we sleep

Article Abstract:

Non-A, non-B hepatitis has been the subject of much research and genetic engineering technology has enabled the development of a clone virus referred to as hepatitis C. Results of recent research published in the New England Journal of Medicine concerning hepatitis C are discussed. The creation of a recombinant clone referred to as hepatitis C virus and the recently developed serologic test for the viral antibody against hepatitis C, anti-HCV, hold tremendous implications for the treatment of this condition. The initiation of a donor screening program will significantly reduce the incidence of transfusion-associated hepatitis C infections. However, benefits in the areas of diagnosis and treatment of acute and chronic hepatitis C conditions are less clear-cut. Problems still include the lag in the detection of infection which sometimes occurs. A standardized six- month follow-up test should be performed in cases of suspected infection before making final diagnosis. The histologic response and the implications for long-term treatment with interferon require more clarification. Transfusion-associated infections account for only a portion of all cases of hepatitis C. According to the Centers for Disease Control, this vector accounts for only 5 to 10 percent of all cases and the source of infection for 40 percent of non-A, non-B hepatitis is still not known. Consequently, blood transfusion is not necessarily the key factor in the spread of this infection. Critical issues needing to be addressed further are the development of additional means of preventative screening and the identification of acute infection.

Care and treatment, Diagnosis, Prevention, editorial, Hepatitis E

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Nosocomial transmission of hepatitis B virus associated with the use of a spring-loaded finger-stick device

Article Abstract:

Patients may be at risk for contracting blood-borne pathogens such as hepatitis B virus (HBV) from spring-loaded finger-stick devices. Health care workers should routinely change the disposable parts of finger-stick devices before each use to avoid transmission of diseases. A 1989 study of 72 hospital patients with diabetes found that 42% of those who had blood taken with finger-stick devices contracted HBV compared to none of those who did not have finger-sticks. Patients' risk of HBV infection increased with the number of finger-sticks they underwent. Three non-diabetic patients who contracted HBV in the hospital during 1989 were compared to 20 non-diabetic patients who did not contract HBV. All of the non-diabetics who contracted HBV underwent blood sampling with finger-stick devices compared to none of the non-infected individuals. Nurses did not routinely change the disposable platform of the finger-stick device after each use. The platform may have been the source of the HBV that infected the patients.

Hepatitis B, Blood diseases, Hematologic diseases

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Transmission of hepatitis B virus to multiple patients from a surgeon without evidence of inadequate infection control

Article Abstract:

Surgical patients may contract hepatitis B virus (HBV) from their surgeon even with proper infection control techniques. Researchers investigated other patients after one patient of a surgeon known to have had hepatitis B became infected. They found that 19 out of 144 patients had also been infected. None of these patients had risk factors for contracting hepatitis B from another source, including other medical staff. Infected patients had received care at two different hospitals, and the surgeon was the only common factor between those hospitals. Genetic analysis revealed that the viral subtype in the surgeon and 13 of the 19 infected patients was identical. Both the surgeon and his coworkers reported that the surgeon used appropriate infection control techniques during surgery. Tiny cuts occurring during suturing, in combination with glove failure, could have transmitted the virus. If the surgeon had been immunized against HBV, the problem could have been avoided.

Health aspects, Surgeons, Hepatitis B virus

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