Case Report
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World J Gastroenterol. Jan 28, 2013; 19(4): 581-585
Published online Jan 28, 2013. doi: 10.3748/wjg.v19.i4.581
Acute hepatitis C virus infection in a nurse trainee following a needlestick injury
Renzo Scaggiante, Liliana Chemello, Roberto Rinaldi, Giovanni Battista Bartolucci, Andrea Trevisan
Renzo Scaggiante, Roberto Rinaldi, Department of Infectious and Tropical Diseases, Padua Hospital, I-35128 Padua, Italy
Liliana Chemello, Department of Medicine, Padua University, I-35128 Padua, Italy
Giovanni Battista Bartolucci, Andrea Trevisan, Department of Molecular Medicine, Padua University, I-35128 Padua, Italy
Author contributions: Trevisan A, Chemello L and Bartolucci GB interpreted the data and wrote the manuscript; Scaggiante R and Rinaldi R took care of the patient.
Correspondence to: Andrea Trevisan, MD, Professor, Department of Molecular Medicine, University of Padova, Via Giustiniani 2, I-35128 Padova, Italy. andrea.trevisan@unipd.it
Telephone: +39-49-8211362 Fax: +39-49-8763238
Received: May 11, 2012
Revised: July 31, 2012
Accepted: August 8, 2012
Published online: January 28, 2013
Abstract

Hepatitis C virus (HCV) infection after biological accident (needlestick injury) is a rare event. This report describes the first case of acute HCV infection after a needlestick injury in a female nursing student at Padua University Hospital. The student nurse was injured on the second finger of the right hand when recapping a 23-gauge needle after taking a blood sample. The patient who was the source was a 72-year-old female with weakly positive anti-HCV test results. Three months after the injury, at the second step of follow-up, a relevant increase in transaminases with a low viral replication activity (350 IU/mL) was observed in the student, indicating HCV infection. The patient tested positive for the same genotype (1b) of HCV as the injured student. A rapid decline in transaminases, which was not accompanied by viral clearance, and persistently positive HCV-RNA was described 1 mo later. Six months after testing positive for HCV, the student was treated with pegylated interferon plus ribavirin for 24 wk. A rapid virological response was observed after 4 wk of treatment, and a sustained virological response (SVR) was evident 6 mo after therapy withdrawal, confirming that the patient was definitively cured. Despite the favourable IL28B gene (rs12979860) CC- polymorphism observed in the patient, which is usually predictive of a spontaneous clearance and SVR, spontaneous viral clearance did not take place; however, infection with this genotype was promising for a sustained virological response after therapy.

Keywords: Biological risk; Acute hepatitis; Hepatitis C infection; Occupational exposure; Antiviral therapy