Prevalence of Viral Hepatitis C among Healthcare Professionals in Intensive Care Units in 2015: a CrossSectional Study from Latvia

Background: Latvia is considered as one of the countries with highest prevalence of hepatitis C virus (HCV) infection in Europe. The prevalence of anti-HCV and HCV-RNA in Latvia was found to be 2.4% and 1.7%, respectively. The prevalence of anti-HCV and HCV-RNA among healthcare professionals in Latvia has never been studied before. Aim: The main objective of the study was to detect HCV infection prevalence in healthcare professionals at Intensive Care Units in Latvia and compare results with population data. The second objective was to analyze healthcare's professional's behavior in case of accident at workplace with potential exposure to HCV infection. Methods: Healthcare professionals from 35 intensive care units of 26 Latvian hospitals participated in the study. Antibodies against HCV (antiHCV) were identified in the venous blood sample of the study participants. Data were collected from April 2014 to April 2015. Study participants with positive anti-HCV had provided repeated blood samples in order to identify the presence of HCV-RNA using real time PCR. Immunoblot antibody test was performed to verify the presence of HCV antibodies in study participants with positive anti-HCV and negative HCV-RNA results. Study participants completed a questionnaire including questions regarding accidents at work, post-exposure preventive actions, and previous HCV testing. The results were summarized and subjected to statistical analysis. Results: One thousand two hundred twenty two medical professionals are employed in the intensive care units in Latvia. All were invited to participate in the study. Of those, 777 healthcare professionals voluntarily participated in the cross-sectional study, with a response rate (RR) of 63.6%. Others – refused. Four hundred and sixty four of 777 (59.7%) study participants indicated accidents at work with potential exposure to HCV. To prevent HCV infection 313 of 464 (67.5%) participants applied local preventive techniques. Seventy six (16.4%) of those who indicated accidents at work with potential exposure to HCV performed such local preventive techniques as wound washing. One hundred and thirty nine injured employees and 98 patients (source of exposure) were screened for presence of HCV. Out of all study subjects 471 (60.6%) had previously been tested for anti-HCV, while 254 (32.7%) had not been tested never before and 52 (6.7%) did not provide answer regarding previous HCV testing. Main findings: From the 777 subjects tested, 18 were positive for anti-HCV and HCV-RNA test was positive in 9 subjects so prevalence of anti-HCV in healthcare professionals included in this study is 2.3% (95% CI 1.3 to 3.4) and HCV-RNA prevalence is 1.2% (95% CI 0.4 to 1.9). Conclusions: The anti-HCV prevalence among healthcare professionals at intensive care units in Latvia is high and is similar to that in the general population. The prevalence of HCV-RNA among healthcare workers is slightly lower than observed in the population. Post-exposure interventions are limited mainly with local preventive techniques for the majority of participants and only small portion carry out all necessary postexposure actions. Approximately one third of healthcare professionals included in study have never been tested for hepatitis C before, despite high risk for exposure at work.