Digestive endoscopy is not a major risk factor for transmitting hepatitis C virus

Alessia Ciancio, Paola Manzini, Franco Castagno, Sergio D'Antico, Paolo Reynaudo, Laura Coucourde, Giovannino Ciccone, Mario Del Piano, Marco Ballarè, Sergio Peyre, Roberto Rizzi, Claudio Barletti, Mauro Bruno, Stefania Caronna, Patrizia Carucci, Wilma De Bernardi Venon, Claudio De Angelis, Anna Morgando, Alessandro Musso, Alessandro RepiciMario Rizzetto, Giorgio Saracco

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Abstract

Background: The potential role of digestive endoscopy as a mode for transmission of hepatitis C virus (HCV) is controversial. Objective: To evaluate the role of digestive endoscopy in transmitting HCV by comparing the incidence of HCV infection in a cohort of patients undergoing endoscopy and in a cohort of blood donors. Design: Prospective cohort study. Setting: 3 endoscopic units and 2 blood banks in northwestern Italy. Patients: The potentially exposed cohort consisted of 9188 out-patients consecutively recruited from 3 endoscopic units. Of 9008 patients negative for antibody to HCV (anti-HCV), 8260 (92%) were retested for anti-HCV 6 months after endoscopy. The unexposed cohort consisted of 51 230 healthy, anti-HCV-negative persons who donated blood at 2 blood banks in the same area and during the same time period; 38 280 of them (75%) were tested again for anti-HCV 6 to 48 months after the first blood donation (95 317 person-years of observation). Measurements: Differences in the anti-HCV seroconversion rate between the exposed cohort (patients undergoing endoscopy) and the unexposed cohort (blood donors). Seroconversion was evaluated by a third-generation enzyme immunoassay for anti-HCV; persons positive for anti-HCV were tested for HCV RNA by polymerase chain reaction. Results: All 8260 persons undergoing endoscopy remained negative for anti-HCV 6 months after the procedure (risk per 1000 persons, 0 [95% CI, 0 to 0.465]); in particular, none of the 912 patients who underwent endoscopy with the same instrument previously used on HCV carriers showed anti-HCV seroconversion (risk per 1000 persons, 0 [CI, 0 to 4.195]). Four blood donors became positive for anti-HCV and HCV RNA (mean follow-up, 2.49 years; 0.042 case per 1000 person-years [CI, 0.011 to 0.107 case per 1000 person-years]); each had undergone minor surgery before the second test. Limitations: In the endoscopy cohort, 8.3% of patients were lost to follow-up. Conclusions: These findings support the hypothesis that properly performed digestive endoscopy is not a major risk factor for the transmission of HCV.

Original languageEnglish
JournalAnnals of Internal Medicine
Volume142
Issue number11
Publication statusPublished - Jun 7 2005

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Hepatitis C Antibodies
Hepacivirus
Endoscopy
Blood Donors
Blood Banks
Minor Surgical Procedures
Lost to Follow-Up
Virus Diseases
DNA-Directed RNA Polymerases
Immunoenzyme Techniques
Italy
Cohort Studies
Outpatients
Observation
Prospective Studies
RNA
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Medicine(all)

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Ciancio, A., Manzini, P., Castagno, F., D'Antico, S., Reynaudo, P., Coucourde, L., ... Saracco, G. (2005). Digestive endoscopy is not a major risk factor for transmitting hepatitis C virus. Annals of Internal Medicine, 142(11).

Digestive endoscopy is not a major risk factor for transmitting hepatitis C virus. / Ciancio, Alessia; Manzini, Paola; Castagno, Franco; D'Antico, Sergio; Reynaudo, Paolo; Coucourde, Laura; Ciccone, Giovannino; Del Piano, Mario; Ballarè, Marco; Peyre, Sergio; Rizzi, Roberto; Barletti, Claudio; Bruno, Mauro; Caronna, Stefania; Carucci, Patrizia; Venon, Wilma De Bernardi; De Angelis, Claudio; Morgando, Anna; Musso, Alessandro; Repici, Alessandro; Rizzetto, Mario; Saracco, Giorgio.

In: Annals of Internal Medicine, Vol. 142, No. 11, 07.06.2005.

Research output: Contribution to journalArticle

Ciancio, A, Manzini, P, Castagno, F, D'Antico, S, Reynaudo, P, Coucourde, L, Ciccone, G, Del Piano, M, Ballarè, M, Peyre, S, Rizzi, R, Barletti, C, Bruno, M, Caronna, S, Carucci, P, Venon, WDB, De Angelis, C, Morgando, A, Musso, A, Repici, A, Rizzetto, M & Saracco, G 2005, 'Digestive endoscopy is not a major risk factor for transmitting hepatitis C virus', Annals of Internal Medicine, vol. 142, no. 11.
Ciancio A, Manzini P, Castagno F, D'Antico S, Reynaudo P, Coucourde L et al. Digestive endoscopy is not a major risk factor for transmitting hepatitis C virus. Annals of Internal Medicine. 2005 Jun 7;142(11).
Ciancio, Alessia ; Manzini, Paola ; Castagno, Franco ; D'Antico, Sergio ; Reynaudo, Paolo ; Coucourde, Laura ; Ciccone, Giovannino ; Del Piano, Mario ; Ballarè, Marco ; Peyre, Sergio ; Rizzi, Roberto ; Barletti, Claudio ; Bruno, Mauro ; Caronna, Stefania ; Carucci, Patrizia ; Venon, Wilma De Bernardi ; De Angelis, Claudio ; Morgando, Anna ; Musso, Alessandro ; Repici, Alessandro ; Rizzetto, Mario ; Saracco, Giorgio. / Digestive endoscopy is not a major risk factor for transmitting hepatitis C virus. In: Annals of Internal Medicine. 2005 ; Vol. 142, No. 11.
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abstract = "Background: The potential role of digestive endoscopy as a mode for transmission of hepatitis C virus (HCV) is controversial. Objective: To evaluate the role of digestive endoscopy in transmitting HCV by comparing the incidence of HCV infection in a cohort of patients undergoing endoscopy and in a cohort of blood donors. Design: Prospective cohort study. Setting: 3 endoscopic units and 2 blood banks in northwestern Italy. Patients: The potentially exposed cohort consisted of 9188 out-patients consecutively recruited from 3 endoscopic units. Of 9008 patients negative for antibody to HCV (anti-HCV), 8260 (92{\%}) were retested for anti-HCV 6 months after endoscopy. The unexposed cohort consisted of 51 230 healthy, anti-HCV-negative persons who donated blood at 2 blood banks in the same area and during the same time period; 38 280 of them (75{\%}) were tested again for anti-HCV 6 to 48 months after the first blood donation (95 317 person-years of observation). Measurements: Differences in the anti-HCV seroconversion rate between the exposed cohort (patients undergoing endoscopy) and the unexposed cohort (blood donors). Seroconversion was evaluated by a third-generation enzyme immunoassay for anti-HCV; persons positive for anti-HCV were tested for HCV RNA by polymerase chain reaction. Results: All 8260 persons undergoing endoscopy remained negative for anti-HCV 6 months after the procedure (risk per 1000 persons, 0 [95{\%} CI, 0 to 0.465]); in particular, none of the 912 patients who underwent endoscopy with the same instrument previously used on HCV carriers showed anti-HCV seroconversion (risk per 1000 persons, 0 [CI, 0 to 4.195]). Four blood donors became positive for anti-HCV and HCV RNA (mean follow-up, 2.49 years; 0.042 case per 1000 person-years [CI, 0.011 to 0.107 case per 1000 person-years]); each had undergone minor surgery before the second test. Limitations: In the endoscopy cohort, 8.3{\%} of patients were lost to follow-up. Conclusions: These findings support the hypothesis that properly performed digestive endoscopy is not a major risk factor for the transmission of HCV.",
author = "Alessia Ciancio and Paola Manzini and Franco Castagno and Sergio D'Antico and Paolo Reynaudo and Laura Coucourde and Giovannino Ciccone and {Del Piano}, Mario and Marco Ballar{\`e} and Sergio Peyre and Roberto Rizzi and Claudio Barletti and Mauro Bruno and Stefania Caronna and Patrizia Carucci and Venon, {Wilma De Bernardi} and {De Angelis}, Claudio and Anna Morgando and Alessandro Musso and Alessandro Repici and Mario Rizzetto and Giorgio Saracco",
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AU - Ciancio, Alessia

AU - Manzini, Paola

AU - Castagno, Franco

AU - D'Antico, Sergio

AU - Reynaudo, Paolo

AU - Coucourde, Laura

AU - Ciccone, Giovannino

AU - Del Piano, Mario

AU - Ballarè, Marco

AU - Peyre, Sergio

AU - Rizzi, Roberto

AU - Barletti, Claudio

AU - Bruno, Mauro

AU - Caronna, Stefania

AU - Carucci, Patrizia

AU - Venon, Wilma De Bernardi

AU - De Angelis, Claudio

AU - Morgando, Anna

AU - Musso, Alessandro

AU - Repici, Alessandro

AU - Rizzetto, Mario

AU - Saracco, Giorgio

PY - 2005/6/7

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N2 - Background: The potential role of digestive endoscopy as a mode for transmission of hepatitis C virus (HCV) is controversial. Objective: To evaluate the role of digestive endoscopy in transmitting HCV by comparing the incidence of HCV infection in a cohort of patients undergoing endoscopy and in a cohort of blood donors. Design: Prospective cohort study. Setting: 3 endoscopic units and 2 blood banks in northwestern Italy. Patients: The potentially exposed cohort consisted of 9188 out-patients consecutively recruited from 3 endoscopic units. Of 9008 patients negative for antibody to HCV (anti-HCV), 8260 (92%) were retested for anti-HCV 6 months after endoscopy. The unexposed cohort consisted of 51 230 healthy, anti-HCV-negative persons who donated blood at 2 blood banks in the same area and during the same time period; 38 280 of them (75%) were tested again for anti-HCV 6 to 48 months after the first blood donation (95 317 person-years of observation). Measurements: Differences in the anti-HCV seroconversion rate between the exposed cohort (patients undergoing endoscopy) and the unexposed cohort (blood donors). Seroconversion was evaluated by a third-generation enzyme immunoassay for anti-HCV; persons positive for anti-HCV were tested for HCV RNA by polymerase chain reaction. Results: All 8260 persons undergoing endoscopy remained negative for anti-HCV 6 months after the procedure (risk per 1000 persons, 0 [95% CI, 0 to 0.465]); in particular, none of the 912 patients who underwent endoscopy with the same instrument previously used on HCV carriers showed anti-HCV seroconversion (risk per 1000 persons, 0 [CI, 0 to 4.195]). Four blood donors became positive for anti-HCV and HCV RNA (mean follow-up, 2.49 years; 0.042 case per 1000 person-years [CI, 0.011 to 0.107 case per 1000 person-years]); each had undergone minor surgery before the second test. Limitations: In the endoscopy cohort, 8.3% of patients were lost to follow-up. Conclusions: These findings support the hypothesis that properly performed digestive endoscopy is not a major risk factor for the transmission of HCV.

AB - Background: The potential role of digestive endoscopy as a mode for transmission of hepatitis C virus (HCV) is controversial. Objective: To evaluate the role of digestive endoscopy in transmitting HCV by comparing the incidence of HCV infection in a cohort of patients undergoing endoscopy and in a cohort of blood donors. Design: Prospective cohort study. Setting: 3 endoscopic units and 2 blood banks in northwestern Italy. Patients: The potentially exposed cohort consisted of 9188 out-patients consecutively recruited from 3 endoscopic units. Of 9008 patients negative for antibody to HCV (anti-HCV), 8260 (92%) were retested for anti-HCV 6 months after endoscopy. The unexposed cohort consisted of 51 230 healthy, anti-HCV-negative persons who donated blood at 2 blood banks in the same area and during the same time period; 38 280 of them (75%) were tested again for anti-HCV 6 to 48 months after the first blood donation (95 317 person-years of observation). Measurements: Differences in the anti-HCV seroconversion rate between the exposed cohort (patients undergoing endoscopy) and the unexposed cohort (blood donors). Seroconversion was evaluated by a third-generation enzyme immunoassay for anti-HCV; persons positive for anti-HCV were tested for HCV RNA by polymerase chain reaction. Results: All 8260 persons undergoing endoscopy remained negative for anti-HCV 6 months after the procedure (risk per 1000 persons, 0 [95% CI, 0 to 0.465]); in particular, none of the 912 patients who underwent endoscopy with the same instrument previously used on HCV carriers showed anti-HCV seroconversion (risk per 1000 persons, 0 [CI, 0 to 4.195]). Four blood donors became positive for anti-HCV and HCV RNA (mean follow-up, 2.49 years; 0.042 case per 1000 person-years [CI, 0.011 to 0.107 case per 1000 person-years]); each had undergone minor surgery before the second test. Limitations: In the endoscopy cohort, 8.3% of patients were lost to follow-up. Conclusions: These findings support the hypothesis that properly performed digestive endoscopy is not a major risk factor for the transmission of HCV.

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