Frequent Transient Hepatitis C viremia without Seroconversion among Healthcare Workers in Cairo, Egypt

Aline Munier (1) , Diaa Marzouk (2) , Florence Legrand-Abravanel (3) , Mai El-Daly (4, 5) , Sylvia Taylor (1) , Rasha Mamdouh (6) , Waleed Salah Eldin (2) , Hanan Ezz El-Arab (2) , Dalia Gaber Sos (2) , Mohamed Momen (2) , Omar Okasha (2) , Lenaig Le Fouler (1) , Mostafa El-Hosini (2) , Jacques Izopet (3) , Mona Rafik (6) , Matthew Albert (7) , Abdel-Hamid Mohamed (4, 8) , Mostafa Kamal Mohamed (6) , Elisabeth Delarocque-Astagneau (1) , Arnaud Fontanet (1)

1 Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology
2 Université Ain Shams
3 CPTP - Centre de Physiopathologie Toulouse Purpan
4 National Hepatology & Tropical Medicine Research Institute
5 Menoufia University
6 Faculty of medicine
7 Immunobiologie des Cellules Dendritiques
8 Minia University

BACKGROUND: With 10% of the general population aged 15-59 years chronically infected with hepatitis C virus (HCV), Egypt is the country with the highest HCV prevalence worldwide. Healthcare workers (HCWs) are therefore at particularly high risk of HCV infection. Our aim was to study HCV infection risk after occupational blood exposure among HCWs in Cairo. METHODOLOGY/PRINCIPAL FINDINGS: The study was conducted in 2008-2010 at Ain Shams University Hospital, 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 with follow-up visits at weeks 2, 4, 8, 12 and 24. During follow-up, anti-HCV, HCV RNA and ALT were tested. 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). The proportion of HCV viremia among index patients was 37%. Of 73 HCWs exposed to HCV RNA from index patients, nine (12.3%; 95%CI, 5.8-22.1%) presented transient viremia, the majority of which occurred within the first two weeks after exposure. None of the workers presented seroconversion or elevation of ALT. CONCLUSIONS/SIGNIFICANCE: HCWs of a general University hospital in Cairo were exposed to a highly viremic patient population. They experienced frequent occupational blood exposures, particularly in early stages of training. These exposures resulted in transient viremic episodes without established infection. These findings call for further investigation of potential immune protection against HCV persistence in this high risk group.

Domains: Life Sciences [q-bio]; Immunology

Aline Munier, Diaa Marzouk, Florence Legrand-Abravanel, Mai El-Daly, Sylvia Taylor, et al.. Frequent Transient Hepatitis C viremia without Seroconversion among Healthcare Workers in Cairo, Egypt. PLoS ONE, 2013, 8 (2), pp.e57835. ⟨10.1371/journal.pone.0057835⟩. ⟨pasteur-01402015⟩