Hepatitis C transient viremia among healthcare workers in Cairo

Very early infection was studied among healthcare workers (HCWs) of Ain Shams University Hospital in Cairo. HCWs reporting an occupational blood exposure at screening, having neither anti-HCV antibodies (anti-HCV) nor HCV RNA, and exposed to a HCV RNA positive patient, were enrolled in a 6-month prospective cohort. Among 597 HCWs who reported a blood exposure, anti-HCV prevalence at screening was 7.2%, not different from that of the general population of Cairo after age-standardization (11.6% and 10.4% respectively, p=0.62). However, the proportion of viremic HCWs among those carrying antibodies (51.2%) was lower compared to that found among the general population (67.7%, DHS 2008).  Most occupational exposure occurred among young residents at early stages of training. The proportion of HCV viremia among index patients was 37%.


Figure prick injury study


Of 73 HCWs exposed to HCV RNA from index patients, nine (12.3%; 95%CI=5.8-22.1%) presented transient viremia, primarily occuring within the first two weeks after exposure. None of the workers presented seroconversion or elevation of ALT. Transient viremia was more common among younger HCWs (?24 years) vs older, and among those who did not use disinfectants after exposure. 


Main conclusion of this study: it showed that a substantial proportion (12.3%) of HCWs exposed to HCV RNA blood developed transient viremia early after exposure, with no subsequent seroconversion. This suggests the acquisition through repeated exposure of immune protection against HCV persistence, which may explain the lack of increased HCV seroprevalence among HCWs compared to the general population despite high exposure, and the low rate of chronic infection (51.2%) among those with HCV antibodies. 


Read more: Munier et al., PLoS ONE, 2013


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