Hepatitis C: more than 90% of transmissions due to surgery

Over 90% of transmission of the virus of hepatitis C virus (HCV) of caregivers were treated due to surgery, according to a study by the Institute of Health Surveillance (VS), published Tuesday in the Weekly Epidemiological Bulletin (BEH) .

Yann Le Strat and his colleagues conducted a InVS modeling based on four situations:

1 / caregiver is viremic for HCV

2 / caregiver is injured during care with a sharp instrument or sharp

3 / instrument stained by the blood of care comes into contact with mucous membranes, an injury or a surgical wound of the patient,

4 / the virus is transmitted to the patient.

The researchers have estimated between 5.5 and 132 the number of transmissions of HCV caregivers cared for the period 2005-2020 is 0.3 to 8.8 transmissions per year, over 90% were attributable to surgery .

They point out, moreover, the "limited quantity" of this mode of transmission compared to others such as drug use character.

This estimate of the transmission of the caregivers is treated according to them, "probably overstated as a proportion of caregivers has been screened for HCV and support."

In an opinion dated September 26, 2003, the Superior Council of Public Hygiene of France (CSHPF) recommended for health professionals practicing and students to prepare for a health profession to know their status vis-à-vis the HCV .

Researchers InVS also decided to assess the impact of various strategies targeted screening of Surgeons.

According to their models, between 5 and 122.9 transmissions would be avoided for the period 2005-2020 by tracking all surgeons for a year in 2005.

The range would be 4.5 to 108.9 with a four-year testing and full screening coverage of 94% and from 4.3 to 104.8 with a screening of five years and a 100% coverage.

However, "it is not easy to focus on a strategy of screening," the authors conclude by stressing the relatively wide intervals obtained and the lack of support costs.

Finally, they consider necessary to integrate the cost of screening to be implemented, stops activity viraemic surgeons and their care, and integrate not only the shortfall for these professionals, but also the social consequences and psychological.

(BEH No. 2-3/2006, January 17, p.26-28, estimate the number of transmissions of HCV caregivers cared for and evaluation of screening strategies caregivers in France, 2005-2020)