NEEDLESTICK HCV EXPOSURE AMONG HEALTH CARE WORKERS

描述(摘自申请者摘要)：免疫学事件 发生在急性丙型肝炎病毒感染中还没有很好的定义， 丙型肝炎病毒在大多数情况下建立持久性的机制也没有 个人。急性丙型肝炎病毒暴露的个体的频率 登山式保护性或“清除”免疫反应尚不清楚。相关性 宿主细胞和体液免疫反应与后续病毒学和 丙型肝炎病毒感染者队列中的临床结果可以提供 对正在进行的开发有效的丙型肝炎疫苗的努力有价值的见解。 城市医院的医护人员感染丙型肝炎病毒的风险很大 当针刺事件发生时暴露。迄今已开展的临床研究 提示丙型肝炎病毒传播的风险在0-6%到10%之间 (分别为丙型肝炎病毒抗体阳性和丙型肝炎病毒聚合酶链式反应阳性的来源患者)。在 马里兰大学医疗系统，25-50例经皮接触丙型肝炎病毒 在1994-1996年间每年都会发生。类似的丙型肝炎病毒针头接触 巴尔的摩的其他医院也报告了这种情况。急性症状性 已经观察到丙型肝炎病毒的传播。该应用程序建议创建一个 支持详细的免疫学和病毒学研究的基础设施 通过针灸事件接触丙型肝炎病毒的个人。一个联盟 感染控制和员工健康专业人员的协作 巴尔的摩医院将前瞻性地识别和招募符合以下条件的个人 接触丙型肝炎病毒。每个人将招收大约100名高危个人 年，在最初的6年中，在7个时间点收集样本 几个月的跟踪调查。按计划行静脉切开术，血浆和外周血 将收集并适当储存单个核细胞。一家诊所 将创建匿名链接到标本储存库的数据库。 这些试剂将用于丙型肝炎病毒的研究 发病机制。

DESCRIPTION (adapted from applicant's abstract): Immunologic events occurring in acute Hepatitis C Virus infection have not been well defined, nor have the mechanisms through which HCV establishes persistence in most individuals. The frequency with which individuals with acute HCV exposure mount protective or "clearing" immune responses is not known. Correlation of host cellular and humoral immune responses with subsequent virologic and clinical outcomes in a cohort of HCV exposed individuals could provide valuable insights for ongoing efforts to develop an effective HCV vaccine. Health care workers in urban hospitals are at significant risk for HCV exposure when needlestick events occur. Clinical studies performed to date suggest that risk of HCV transmission lies between 0-6% to 10% of episodes (HCV antibody +, vs. HCV PCR+ source patients, respectively). At the University of Maryland Medical System, 25-50 percutaneous HCV exposures occurred each year between 1994-1996. Similar HCV needlestick exposure rates have been reported at other Baltimore hospitals. Acute symptomatic HCV transmission has been observed. The application proposes to create an infrastructure to support detailed immunological and virological studies of individuals exposed to HCV through needlestick events. A coalition of Infection Control and Employee Health professionals at collaborating Baltimore hospitals will prospectively identify and enroll individuals with HCV exposure. Approximately 100 at-risk individuals will be enrolled each year, with specimen collection at seven time points during the initial 6 months of follow-up. At scheduled phelbotomy, plasma and peripheral blood mononuclear cells will be collected and appropriately stored. A clinical data base, anonymously linked to the specimen repository, will be created. These reagents will be made available for investigations of HCV pathogenesis.