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Epidemiological and phylogenetic evidence for patient‐to‐patient hepatitis C virus transmission during sclerotherapy of varicose veins
Author(s) -
de Lédinghen Victor,
Trimoulet Pascale,
Cazajous Géraldine,
Bernard PierreHenri,
Schrive MarieHélène,
Foucher Juliette,
Faure Muriel,
Castéra Laurent,
Vergniol Julien,
Amouretti Michel,
Fleury Hervé,
Couzigou Patrice
Publication year - 2005
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.20356
Subject(s) - sclerotherapy , medicine , hepatitis c virus , varicose veins , epidemiology , hepatitis c , genotype , virology , surgery , virus , biology , genetics , gene
The aim of this study was to provide evidence for patient‐to‐patient nosocomial hepatitis C virus (HCV) transmission during sclerotherapy of varicose veins. Forty‐three patients who had evidence of current infection by genotype 2 HCV have had sclerotherapy by the same physician. Based on this observation, a detailed epidemiological questionnaire on risk factors for HCV in genotype 2 infected patients was conducted. Seventeen sequences in the hypervariable region 1 (HVR1) of the HCV genome obtained from 17 HCV RNA positive patients with a past history of sclerotherapy, were compared with 17 sequences derived from genotype 2 patients with no past history of sclerotherapy, and with 25 sequences sampled from GenBank. Two hundred seven genotype 2 HCV infected patients were included. The main risk factors for HCV infection were transfusion (n = 76), drug use (n = 6), and sclerotherapy of varicose veins (n = 62 including 43 (20.8%) by the same physician), other or unknown (n = 76). These sclerotherapy sessions were carried out in the 1980s for many years. Five of these 43 patients had jaundice within a few weeks after a sclerotherapy session. Sequence analysis of HVR1 from 17 patients who had sclerotherapy by the same physician revealed that they were all infected with HCV genotype 2c. The phylogenetic tree indicated clustering of the patients with a past history of sclerotherapy. The method by which infection was likely to have been transmitted was probably the use of a single vial for multiple patients. This study provides strong evidence that sclerotherapy of varicose veins is a risk factor for HCV infection. J. Med. Virol. 76:279–284, 2005. © 2005 Wiley‐Liss, Inc.