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. 2022 Apr;24(2):e13775.
doi: 10.1111/tid.13775. Epub 2022 Jan 31.

Caregiver exposure to hepatitis C virus following transplantation with hepatitis C viremic donor organs: A case series

Michelle Kim  1 , Jeffrey Stern  1 , Ryan Robalino  1 , Elaina P Weldon  1 , Nicole M Ali  1 , Sapna A Mehta  1 , Zoe A Stewart  1 , Bonnie E Lonze  1
Affiliations

Caregiver exposure to hepatitis C virus following transplantation with hepatitis C viremic donor organs: A case series

Michelle Kim et al. Transpl Infect Dis. 2022 Apr.

Abstract

Direct-acting antiviral (DAA) therapeutics have ushered in an era in which transplanting organs from donors infected with hepatitis C virus (HCV+) into recipients without (HCV-) is an increasingly common practice. Rare but potentially life-threatening events have been reported in recipients of HCV+ organs. Since 2018 at our institution, 182 HCV- patients have received HCV+ donor organs. Here, we retrospectively reviewed cases in which recipients' family member caregivers reported sustaining needlestick exposures at home following discharge of the transplant recipient from the hospital. Caregiver needlestick exposures were passively reported in three cases of HCV+ into HCV- transplants (1.64% of such cases at our center). In all instances, the exposed individuals were aiding in diabetic management and the exposure occurred via lancets or insulin needles. In one case, the recipient viral load was undetectable at the time of the exposure but in the other two, recipients were viremic, putting their family members at risk to contract HCV infection. Surveillance for the exposed individuals was undertaken and no transmissions occurred. For centers performing HCV+ into HCV- transplants, it is important that informed consent includes discussion of potential secondary risks to family members and caregivers. Further, protocols for postexposure surveillance and for the acquisition of DAA treatment in the event of a secondary transmission should be in place.

Keywords: caregiver; hepatitis C infection; infectious exposure; posttransplant infections.

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References

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