Saturday, June 10, 2017

Management of a nurse who accidentally stabs himself with a used needle from a patient infected with the HCV...



A 34-yr-old CCU nurse accidentally stabs himself with a used needle from a patient infected with the HCV. He attends the occupational health dept and asks for advice. Which would be the most appropriate next step suggested by the occupational health doctor?

A. Monthly hepatitis C antibody testing
B. Monthly hepatitis C RT PCR/PCR testing
C. 6 months’ ribavirin therapy
D. 6 months’ lamivudine therapy
E. 6 months of weekly interferon therapy

Answer:
B. Monthly hepatitis C RT PCR/PCR testing

Discussion: Acute hepatitis C is now amenable to treatment and very high success rates have been reported in a relatively recent landmark paper published in the New England Journal of Medicine. The most appropriate test is with PCR as this becomes positive prior to IgG levels. If seroconversion
occurs, the nurse would be offered interferon (usually in combination with ribavirin), which would afford a greater than 90% chance of cure. Length of therapy depends on the Hepatitis C genotype.

Lamivudine is used for hepatitis B and HIV treatment.

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