Digestive endoscopy and HCV transmission.
Fiche publication
Date publication
janvier 2006
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BRONOWICKI Jean-Pierre
Tous les auteurs :
Bronowicki JP
Lien Pubmed
Résumé
Background: The potential role of digestive endoscopy a mode for transmission of hepatitis C virus (HCV) is controversial. Objective: To evaluate the role of digestive endoscopy transmitting HCV by comparing the incidence of H( infection in a cohort of patients undergoing endoscopy a in a cohort of blood donors Design: Prospective cohort study. Setting: Three endoscopic units and two blood banks northwestern Italy. Patients: The potentially exposed cohort consisted 188 outpatients consecutively recruited from three endoscopic units. Of 9008 patients negative for antibody HCV (anti-HCV), 8260 (92%) were retested for an HCV 6 months after endoscopy. The unexposed cohort consisted of 51,230 healthy, anti-HCV-negative persons who donated blood at two blood banks in the same area a during the same time period; 38,280 of them (75%) were tested again for anti-HCV 6-48 months after the first blood donation (95,317 person-years of observation). Measurements: Differences in the anti-HCV serocon-version rate between the exposed cohort (patients under-going endoscopy) and the unexposed cohort (blood donor Seroconversion was evaluated by a third-generation enzyme immunoassay for anti-HCV; persons positive is anti-HCV were Results: All 8260 persons undergoing endoscopy 1 remained negative for anti-HCV 6 months after the I procedure (risk per 1000 persons, 0 [95% CI, 0-0.465]); in particular, none of the 912 patients who underwent endoscopy with the same instrument previously used on HCV carriers showed anti-HCV seroconversion (risk per 000 persons, 0 [CI, 0-4.195]). Four blood donors became positive for anti-HCV and HCV RNA (mean follow-up, 2.49 years; 0.042 case per 1000 person-years [CI, 0.011-0.107 case per 1000 person-years]); each had undergone 1 minor surgery before the second test Limitations: In the endoscopy cohort, 8.3% of patients were lost to follow-up. Conclusions: These findings support the hypothesis that I properly performed digestive endoscopy is not a major risk factor for the transmission of HCV.
Référence
J Hepatol. 2006 Jan;44(1):246-7.