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Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital

BACKGROUND: As a blood-borne pathogen, hepatitis C virus (HCV) has long been a major threat associated with needle-stick injuries (NSIs) mainly because no vaccine is available for HCV. Following an NSI, we usually test the source patient for HCV antibody (HCV-Ab). Since HCV-Ab positivity does not ne...

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Autores principales: Okushin, Kazuya, Suzuki, Rie, Tsutsumi, Takeya, Okamoto, Koh, Ikeuchi, Kazuhiko, Kado, Akira, Minatsuki, Chihiro, Minami-Kobayashi, Yuka, Satoh, Nobuhiko, Ikeda, Mahoko, Harada, Sohei, Enooku, Kenichiro, Fujinaga, Hidetaka, Yotsuyanagi, Hiroshi, Koike, Kazuhiko, Moriya, Kyoji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086119/
https://www.ncbi.nlm.nih.gov/pubmed/33931015
http://dx.doi.org/10.1186/s12879-021-06117-4
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author Okushin, Kazuya
Suzuki, Rie
Tsutsumi, Takeya
Okamoto, Koh
Ikeuchi, Kazuhiko
Kado, Akira
Minatsuki, Chihiro
Minami-Kobayashi, Yuka
Satoh, Nobuhiko
Ikeda, Mahoko
Harada, Sohei
Enooku, Kenichiro
Fujinaga, Hidetaka
Yotsuyanagi, Hiroshi
Koike, Kazuhiko
Moriya, Kyoji
author_facet Okushin, Kazuya
Suzuki, Rie
Tsutsumi, Takeya
Okamoto, Koh
Ikeuchi, Kazuhiko
Kado, Akira
Minatsuki, Chihiro
Minami-Kobayashi, Yuka
Satoh, Nobuhiko
Ikeda, Mahoko
Harada, Sohei
Enooku, Kenichiro
Fujinaga, Hidetaka
Yotsuyanagi, Hiroshi
Koike, Kazuhiko
Moriya, Kyoji
author_sort Okushin, Kazuya
collection PubMed
description BACKGROUND: As a blood-borne pathogen, hepatitis C virus (HCV) has long been a major threat associated with needle-stick injuries (NSIs) mainly because no vaccine is available for HCV. Following an NSI, we usually test the source patient for HCV antibody (HCV-Ab). Since HCV-Ab positivity does not necessarily indicate current infection, HCV RNA is further examined in patients positive for HCV-Ab. Direct-acting antivirals (DAAs) have enabled us to treat most HCV-infected patients; therefore, we speculate that the rate of HCV RNA positivity among HCV-Ab-positive patients decreased after the emergence of DAAs. This cross-sectional study was performed to investigate the change in the actual HCV RNA positivity rate in source patients before and after the interferon (IFN)-free DAA era. METHODS: This was a cross-sectional study of NSI source patients at a tertiary academic hospital in Japan from 2009 to 2019. IFN-free DAA regimens were first introduced in Japan in 2014. Accordingly, we compared HCV status of NSI source patients that occurred between 2009 and 2014 (the era before IFN-free DAAs) with those that occurred between 2015 and 2019 (the era of IFN-free DAAs) in a tertiary care hospital in Japan. RESULTS: In total, 1435 NSIs occurred, and 150 HCV-Ab-positive patients were analyzed. The proportion of HCV RNA-positive patients significantly changed from 2009 through 2019 (p = 0.005, Cochran–Armitage test). Between 2009 and 2014, 102 source patients were HCV-Ab-positive, 78 of whom were also positive for HCV RNA (76.5%; 95%CI, 67.4–83.6%). Between 2015 and 2019, 48 patients were HCV-Ab-positive, 23 of whom were also positive for HCV RNA (47.9%; 95%CI, 34.5–61.7%; p = 0.0007 compared with 2009–2014). In the era of IFN-free DAAs, 9 of 23 HCV RNA-negative patients (39.1%) and 2 of 22 HCV RNA-positive patients (9.1%) were treated with an IFN-free combination of DAAs (p = 0.0351). Regarding the departments where NSIs occurred, HCV RNA-negative patients were predominant in departments not related to liver diseases in the era of IFN-free DAAs (p = 0.0078, compared with 2009–2014). CONCLUSIONS: Actual HCV RNA positivity in source patients of NSIs decreased after the emergence of IFN-free DAAs. IFN-free DAAs might have contributed to this reduction, and HCV RNA-negative patients were predominant in departments not related to liver diseases in the era of IFN-free DAAs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06117-4.
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spelling pubmed-80861192021-04-30 Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital Okushin, Kazuya Suzuki, Rie Tsutsumi, Takeya Okamoto, Koh Ikeuchi, Kazuhiko Kado, Akira Minatsuki, Chihiro Minami-Kobayashi, Yuka Satoh, Nobuhiko Ikeda, Mahoko Harada, Sohei Enooku, Kenichiro Fujinaga, Hidetaka Yotsuyanagi, Hiroshi Koike, Kazuhiko Moriya, Kyoji BMC Infect Dis Research BACKGROUND: As a blood-borne pathogen, hepatitis C virus (HCV) has long been a major threat associated with needle-stick injuries (NSIs) mainly because no vaccine is available for HCV. Following an NSI, we usually test the source patient for HCV antibody (HCV-Ab). Since HCV-Ab positivity does not necessarily indicate current infection, HCV RNA is further examined in patients positive for HCV-Ab. Direct-acting antivirals (DAAs) have enabled us to treat most HCV-infected patients; therefore, we speculate that the rate of HCV RNA positivity among HCV-Ab-positive patients decreased after the emergence of DAAs. This cross-sectional study was performed to investigate the change in the actual HCV RNA positivity rate in source patients before and after the interferon (IFN)-free DAA era. METHODS: This was a cross-sectional study of NSI source patients at a tertiary academic hospital in Japan from 2009 to 2019. IFN-free DAA regimens were first introduced in Japan in 2014. Accordingly, we compared HCV status of NSI source patients that occurred between 2009 and 2014 (the era before IFN-free DAAs) with those that occurred between 2015 and 2019 (the era of IFN-free DAAs) in a tertiary care hospital in Japan. RESULTS: In total, 1435 NSIs occurred, and 150 HCV-Ab-positive patients were analyzed. The proportion of HCV RNA-positive patients significantly changed from 2009 through 2019 (p = 0.005, Cochran–Armitage test). Between 2009 and 2014, 102 source patients were HCV-Ab-positive, 78 of whom were also positive for HCV RNA (76.5%; 95%CI, 67.4–83.6%). Between 2015 and 2019, 48 patients were HCV-Ab-positive, 23 of whom were also positive for HCV RNA (47.9%; 95%CI, 34.5–61.7%; p = 0.0007 compared with 2009–2014). In the era of IFN-free DAAs, 9 of 23 HCV RNA-negative patients (39.1%) and 2 of 22 HCV RNA-positive patients (9.1%) were treated with an IFN-free combination of DAAs (p = 0.0351). Regarding the departments where NSIs occurred, HCV RNA-negative patients were predominant in departments not related to liver diseases in the era of IFN-free DAAs (p = 0.0078, compared with 2009–2014). CONCLUSIONS: Actual HCV RNA positivity in source patients of NSIs decreased after the emergence of IFN-free DAAs. IFN-free DAAs might have contributed to this reduction, and HCV RNA-negative patients were predominant in departments not related to liver diseases in the era of IFN-free DAAs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06117-4. BioMed Central 2021-04-30 /pmc/articles/PMC8086119/ /pubmed/33931015 http://dx.doi.org/10.1186/s12879-021-06117-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Okushin, Kazuya
Suzuki, Rie
Tsutsumi, Takeya
Okamoto, Koh
Ikeuchi, Kazuhiko
Kado, Akira
Minatsuki, Chihiro
Minami-Kobayashi, Yuka
Satoh, Nobuhiko
Ikeda, Mahoko
Harada, Sohei
Enooku, Kenichiro
Fujinaga, Hidetaka
Yotsuyanagi, Hiroshi
Koike, Kazuhiko
Moriya, Kyoji
Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital
title Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital
title_full Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital
title_fullStr Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital
title_full_unstemmed Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital
title_short Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital
title_sort change in hepatitis c virus positivity among needle-stick injury source patients: a 10-year experience in a japanese tertiary hospital
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086119/
https://www.ncbi.nlm.nih.gov/pubmed/33931015
http://dx.doi.org/10.1186/s12879-021-06117-4
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