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Increased Risk of Transmission of Hepatitis C in Open Heart Surgery Compared With Vascular and Pulmonary Surgery

Olsen, Karina; Dahl, Per Erling; Paulssen, Eyvind J.; Husebekk, Anne; Widell, Anders LU and Busund, Rolf (2010) In Annals of Thoracic Surgery 90(5). p.1425-1431
Abstract
Background. We report a case of patient-to-surgeon transmission of hepatitis C virus (HCV), and the subsequent transmission of HCV to surgical patients. Methods. In 2007, a cardiac surgeon tested positive for hepatitis C. A complete look-back investigation was initiated that involved screening of all patients on the surgeon's operating lists between September 2004 and April 2007. Genotyping and phylogenetic analyses were performed where HCV RNA was detected. Results. Of the 499 patients invited to HCV testing, 431 responded, 13 of whom were found anti-HCV positive. One patient, who had surgery in August 2005, was found most likely to be the source of transmission to the surgeon. Of the 270 patients who had surgery after this incident, 10... (More)
Background. We report a case of patient-to-surgeon transmission of hepatitis C virus (HCV), and the subsequent transmission of HCV to surgical patients. Methods. In 2007, a cardiac surgeon tested positive for hepatitis C. A complete look-back investigation was initiated that involved screening of all patients on the surgeon's operating lists between September 2004 and April 2007. Genotyping and phylogenetic analyses were performed where HCV RNA was detected. Results. Of the 499 patients invited to HCV testing, 431 responded, 13 of whom were found anti-HCV positive. One patient, who had surgery in August 2005, was found most likely to be the source of transmission to the surgeon. Of the 270 patients who had surgery after this incident, 10 became infected, giving an estimated rate of transmission of 3.7%. The HCV polymerase chain reaction positive samples were found to be the same genotype 1a strain by phylogenetic analyses. All the 10 subsequently infected patients had undergone open heart surgery, whereas none of the 103 noncardiac patients became infected, giving an estimated risk of transmission during open heart surgery of 6.0% (95% confidence interval [3.3% to 10.7%]). Conclusions. The transmission rate from an HCV positive surgeon to patients in a cardiothoracic setting was higher than previously reported and significantly higher during open heart surgery compared with vascular and pulmonary surgery. These results indicate the need for unequivocal routines for testing and handling of HCV positive health care workers and patients. (Ann Thorac Surg 2010; 90: 1425-31) (C) 2010 by The Society of Thoracic Surgeons (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Thoracic Surgery
volume
90
issue
5
pages
1425 - 1431
publisher
Elsevier
external identifiers
  • wos:000283352200014
  • scopus:78049284399
ISSN
1552-6259
DOI
10.1016/j.athoracsur.2010.06.053
language
English
LU publication?
yes
id
4d5ecc99-982b-4068-bea9-5252118aa001 (old id 1721192)
date added to LUP
2010-12-01 11:34:42
date last changed
2018-05-29 10:21:30
@article{4d5ecc99-982b-4068-bea9-5252118aa001,
  abstract     = {Background. We report a case of patient-to-surgeon transmission of hepatitis C virus (HCV), and the subsequent transmission of HCV to surgical patients. Methods. In 2007, a cardiac surgeon tested positive for hepatitis C. A complete look-back investigation was initiated that involved screening of all patients on the surgeon's operating lists between September 2004 and April 2007. Genotyping and phylogenetic analyses were performed where HCV RNA was detected. Results. Of the 499 patients invited to HCV testing, 431 responded, 13 of whom were found anti-HCV positive. One patient, who had surgery in August 2005, was found most likely to be the source of transmission to the surgeon. Of the 270 patients who had surgery after this incident, 10 became infected, giving an estimated rate of transmission of 3.7%. The HCV polymerase chain reaction positive samples were found to be the same genotype 1a strain by phylogenetic analyses. All the 10 subsequently infected patients had undergone open heart surgery, whereas none of the 103 noncardiac patients became infected, giving an estimated risk of transmission during open heart surgery of 6.0% (95% confidence interval [3.3% to 10.7%]). Conclusions. The transmission rate from an HCV positive surgeon to patients in a cardiothoracic setting was higher than previously reported and significantly higher during open heart surgery compared with vascular and pulmonary surgery. These results indicate the need for unequivocal routines for testing and handling of HCV positive health care workers and patients. (Ann Thorac Surg 2010; 90: 1425-31) (C) 2010 by The Society of Thoracic Surgeons},
  author       = {Olsen, Karina and Dahl, Per Erling and Paulssen, Eyvind J. and Husebekk, Anne and Widell, Anders and Busund, Rolf},
  issn         = {1552-6259},
  language     = {eng},
  number       = {5},
  pages        = {1425--1431},
  publisher    = {Elsevier},
  series       = {Annals of Thoracic Surgery},
  title        = {Increased Risk of Transmission of Hepatitis C in Open Heart Surgery Compared With Vascular and Pulmonary Surgery},
  url          = {http://dx.doi.org/10.1016/j.athoracsur.2010.06.053},
  volume       = {90},
  year         = {2010},
}