Exposure to Hepatitis C Virus Clinical Trial
Official title:
ANRS 12320 IMMHoTHep : Investigative Mathematical Modeling of Hospital Transmission of Hepatitis C
This project is a prospective observational cohort study to quantify the risk of acquiring Hepatitis C virus (HCV) infection for patients and healthcare workers in Ain Shams University Teaching Hospital, Cairo, Egypt through: 1) identifying typical patient trajectories within the hospital; and 2) assessing the ward-specific risk based on the type and number of procedures performed and the prevalence of HCV viremia in patients within each ward.
Hepatitis C virus (HCV) is a blood-borne virus and its major route of transmission include
blood transfusion, medical injection and procedure, and injecting drug use. In Egypt, the
origin of the HCV epidemic has been attributed to a mass treatment of schistosomiasis
between 1960 and 1984, when intravenous injections with antimony salts were given to 3-5
million people older than 6 years of age. Insufficient sterilization of needles and syringes
was considered to be responsible for HCV transmission at that time. In order to control the
spread of HCV in Egypt, the Egyptian Ministry of Health and Population established the
National Committee for the Control of Viral Hepatitis. By 2008, this committee developed a
National Control Strategy for Viral Hepatitis which has recommended prevention and education
campaigns targeting general population and also healthcare workers (HCW). In their
occupational environment, HCWs are frequently exposed to multiple blood-borne pathogens,
including HCV. Several risk factors for HCV acquisition among patients and HCWs within a
hospital ward have been identified, including a high prevalence of HCV infection in the
ward, understaffing, workplace characteristic, and human factors such as inexperience or
unfamiliar with equipment. However, to the investigators' knowledge, the overall risk of HCV
acquisition associated with hospital stay has never been evaluated in Egypt. Also, control
measures to reduce the risk of HCV transmission in hospital settings, based on a global
assessment of healthcare provider logistics and performance, have never been proposed in
Egypt.
In this project, the investigators assume that HCV will be transmitted to both hospital
staff and patients. Given the slow dynamics of the HCV epidemic, the investigators further
hypothesize that, in the short term, the prevalence of HCV viremia among patients will be
constant. Therefore, the investigators are led to conclude that HCV transmission risk may be
inferred from a detailed description of individual trajectories of patients or staff within
the hospital.
;