[Model-based estimates of the risk of HCV transmission from infected patients to gynaecologic and obstetric staff].

Unlabelled: The risk of acquiring the hepatitis C virus (HCV) through percutaneous occupational exposure is dependent on three key variables: number of injuries, probability of a percutaneous injury transmitting HCV and prevalence of HCV infection in the patient population.

Objective: To estimate the prevalence of HCV infection in the gynaecological/obstetric patient population and thereafter estimate the risk of HCV transmission to personnel through occupational exposure.

Methods: The prevalence of anti-HCV was estimated through an anonymous serosurvey of gynaecological/ obstetric patients in 15 randomly selected hospitals in West Pomerania, Poland, from February 2008 to January 2009. Using own published data on the percutaneous injuries during gynaecological/obstetric surgeries and results obtained from serologic survey, the risk of annual occupational transmission of HCV to personnel was then derived with the use of a mathematical model.

Results: The prevalence of anti-HCV infection for 528 gynaecological/obstetric patients, aged 18-83 (median 45), was 0.76% (4/528; 95%CI: 0.29-1.93%). The estimated risk of HCV transmission from an HCV infected patient to an uninfected staff member may vary over a wide range (0.00007-0.1%), being dependent on the type of exposure; the average risk for a midwife was 0.0038% per annum (0.15% risk over a 40 year professional career). The estimated risk for a gynaecologist/obstetrician was 0.0076% and 0.30% respectively.

Conclusions: The risk of an individual member of a gynaecological/obstetric staff acquiring HCV through occupational exposure is low, however a credible hazard still exists. One in 130 patients hospitalized at gynaecological/obstetric wards showed markers of HCV infection. Therefore, staff members should be encouraged to observe standard precautions regarding sharps injury prevention and present themselves for post-exposure management in case of need.