Acute hepatitis C virus infection in a nurse trainee following a needlestick injury

摘要

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 followup,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.