HCV May Be Transmitted via
"Nosocomial" transmission in
healthcare settings is the second most common route of hepatitis C virus (HCV)
transmission, after shared use of needles and other drug injection equipment.
It is well known that HCV may be
transmitted via accidental needle-sticks, but contact with the virus on
contaminated surfaces in healthcare facilities may also play a role. Prior
research indicates that HCV can remain viable on surfaces for up to 16 hours.
As reported in the September 1, 2008 issue of Clinical Infectious Diseases,
French researchers conducted a prospective observational study to assess the
roles of environmental contamination and non-compliance with standard
precautions in cross-transmission of HCV between patients in a hemodialysis
Patients undergoing long-term kidney dialysis at a French university hospital
were systematically screened, revealing 2 cases of HCV transmission. An
investigation was then launched to determine whether the patients were infected
in the hemodialysis unit. Environmental contamination by blood and HCV RNA was
assessed, as was compliance with accepted infection-control precautions such as
hand-washing and use of gloves.
patients experienced HCV seroconversion during the study period.
Phylogenetic analyses showed that 1 of these patients was infected with the
same strain as a chronically infected patient also treated in the unit.
740 environmental surface samples, 82 (11%) contained hemoglobin (a
component of blood).
(7%) of the surface samples contained HCV RNA.
rate of compliance with hand hygiene was 37%.
Gloves were immediately removed after patient care in 33% of cases.
hand hygiene and a low ratio of nurses to patients were independent
predictors of the presence of hemoglobin on environmental surfaces.
"Blood-contaminated surfaces may be a source of HCV
cross-transmission in a hemodialysis unit," the study authors concluded. "Strict
compliance with hand hygiene and glove use and strict organization of care
procedures are needed to reduce the risk of HCV cross-transmission among
patients undergoing hemodialysis."
Infection Control Unit, French National Reference Center for Viral Hepatitis
B, C, and delta, Department of Virology & INSERM U635 and Nephrology Ward, Henri
Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris 12,
E Girou, S Chevaliez, D Challine, and others. Determinant roles of environmental
contamination and noncompliance with standard precautions in the risk of
hepatitis C virus transmission in a hemodialysis unit. Clinical Infectious
Diseases 47(5): 627-633. September 1, 2008. (Abstract).