needle stick and presence of viral load

[concernedrn]

How long should it take for a viral load to show in a person follow a dirty needle stick?

[SonicBandaid]

First, the likelihood of actually contracting HCV in that manner is statistically small, probably less than 1%.

Second, and possibly because of the small size of the innoculum inherent in this manner of transmsion, it may take weeks to develop detectable HCV RNA and many months to develop detectable antibody (some may not do this for 9-12 months).  I generally test people exposed in this manner at time 0, 3, 6 and 12 months.
Good luck!
Cheers,
Sonic

[elizabethanncothron10/9/63]

i'm sorry i totally disagree, all is it takes is just 1 time 2 b stuck by a dirty needle 2 contract hcv or any other disease. beleive i know thats all it took 4 me, 1 blood transfusion with dirty blood! i also new someone that got ahold of a dirty needle & contracted hcv, she died 3 yrs. ago @ age 42.  i'm sorry but i'm not trying 2 scare u, these r just the facts!  good luck, & god bless  elizabeth

[Alady1620]

I disagree too.  A needle stick should be taken very seriously no matter what the odds.

I believe I read it could take up to 6 months but I'm not sure.  There are tests and meds the doctor can give you.  I think you should consult a physician ASAP.

[BThompson4]

I don't know how you can compare sonic's statement about a needle stick with actually getting a pint of hep c laden blood pumped into your veins.  Those are very different occurences.  

The needle stick gives you a relatively small chance of getting the virus; the transfusion of tainted blood pretty much guarantees you will be infected.

Sorry for your horrible luck with the transfusion.

[honey11]

Hmmm,,,,good question!  I would think that if you were stuck by a needle that was tainted, that the hep if you contracted would show up pretty quick.  I could be wrong but once in bloodstream,,,it multiplies fast.   Get tested and don't take it lightly,,Good Luck!

[missy60051]

Working enviorment (*can't spell anymore)  who cares!
Any way if sharing needles for drug use thats one thing, but working as a nurse and a finger stick from a hep c pt. I was told was to be very unlikely, but still you need to be tested to be safe.   Sonic says 1 % ,I was told 10% and very unlikely.
Missy

[Catll]

Sorry  had to disagree with Sonic again, my bad …
I think you should provide supported links also. (to avoid misrepresentation in the future)

• To be on the safe side I would say 3%- 10% . ….Will depend on type of the needle, ...gloves people use, status of immune system…etc

http://lib.bioinfo.pl/pmid:1427651
“Their hepatitis was generally subclinical or self-limited and transient, except for one patient in whom liver enzyme elevation persisted along with the antibodies. In our study, the risk of hepatitis C virus transmission from a single needlestick accident with hepatitis C virus RNA-positive blood was 10%, considerably higher than the 4% estimated in a previous study.”

http://www.creativeintensity.com/smking/HepCFact.htm
“The risk of transmission as a result of a needlestick injury from a known positive source is estimated to be 4% to 10%.1
Infection Control in the Physician's Office, 2004 Edition (PDF at CPSO site)”
http://www.medscape.com/viewarticle/412416
“My first action is always to reassure the needle-stick patient, telling him or her to remain calm. Several prospective studies have shown that only 5% to 10% of needle-stick accidents will result in the development of hepatitis C.[1,2]”
• http://www.medscape.com/viewarticle/412416
“The clinical symptoms and signs, results of biochemical laboratory studies, and liver histology associated with acute hepatitis C are similar to those of other forms of acute viral hepatitis and thus, the disease can only be distinguished by virologic testing.[4,7] Typically, the hepatitis C virus (HCV) RNA becomes positive 2 weeks after exposure and remains positive throughout the acute illness. The alanine aminotransferase (ALT) tests, however, do not become abnormal until weeks 4-8, with symptoms appearing by week 6. The anti-HCV antibody enzyme-linked immunosorbent assay (ELISA) generally does not become positive until 6-8 weeks after exposure.[7-16] Therefore, the HCV RNA test is the most valuable tool for detecting an acute infection, and we use it routinely at our institution to identify infection after a needle stick. If the HCV RNA is negative at week 2, we repeat the test 4 weeks later, and if it remains negative, the patient is advised that there has been no transmission. We perform baseline HCV ELISA antibody testing and hepatitis B surface antigen testing in this setting as well. Specific IgM antibodies are helpful markers of acute disease in the setting of hepatitis A and B; however, IGM anti-HCV is not a reliable marker for acute disease in the case of hepatitis C.[17-19] Therefore, this test is not routinely used. To confirm the results of a positive HCV-RNA test, we perform the anti-HCV antibody study 8-12 weeks after exposure”
“
If your immune system does not respond and not induced by Interferon your body will not realize for awhile that you have a virus…. Giving a multifactor which could effect HCV 12 month check would be a good idea too along with 6… but most likely virus would be detectable from 2-3 weeks to 3 month.

Once again it was just: my opinion...

[rosebud57]

as i write this it is with healthcare  professional in mind, but i wonder, if someone is stuck with a known contamination of hcv, is there no protocol but to wait and watch?  for example, couldn't a person take a short course of tx?
anyone ever hear of something like that?

[Mr Liver]

Anti-hcv antibodies are usually detectable within 7-21 days. If the antibodies are found promptly, and tx is intiated, the clearance rate is 100% for a 30 day tx regimen.

Yours in truth,
Mr Liver

[SonicBandaid]

Again, I am NOT saying it shouldn't be taken seriously; on the contrary, as I said I routinely follow up all people who have been "stuck" for over a year with serial testing. I do agress that if acute HCV is detected in this was that acute interferon / ribavirin therapy SHOULD be instituted and (as discussed in Replicative homeostasis III http://www.virologyj.com/content/4/1/29), clearance rates for those who have acute HCV treated urgently exceed 90% FOR ALL GENOTYPES.

However, needlestick accidents (meaning, transmission of viruses by hypodermic or intravenous needles that have been used on other patients) is QUITE different from transmission by transfusion of contaminated blood or blood products.  In this latter situation, infection is virtually universal.  In true needlestick accidents, while transmission obviously does occur, and may cause rapid seroconversion and development of significant hepatitis, this is actually a very rare event.  For a start, most needlstick accidents (and in many countries, including three where I have worked, reporting this and investigating it in the manner I have described above is a LEGAL requirement, and hence there are accurate statistics on which to base decision making) occur when the original patient on whom the contaminated needles were used are uninfected by known viruses; the point prevalence of hepatitis carriage within hospitals (the situation that this issue most commonly arises) is less than 5%, therefore the probability of needlestick transmission, right off the bat, is less than 1:20.  What about from KNOWN cariiers?

Large studies of the risk of transmsiion of HCV from KNOWN HCV positive individuals have been carried out (see references below) and in the biggest of these (Chung et al in Japan), the risk of HCV transmission was less then 1:250 incidents needlsticks from individuals PROVEN to have HCV.  In otherwords, the event is rare.  I am not downplaying its importance (obviously, infecting healthcare workers in this way IS a MAJOR concern); but it is, STATISTICALLY, very rare.  But you should still be careful.
Cheers,
Sonic

References

1. Hasan F, Askar H, Al Khalidi J, Al Shamali M, Al Kalaoui M, Al Nakib B: Lack of transmission of hepatitis C virus following needlestick accidents. Hepatogastroenterology 1999, 46:1678-1681.
2. Hamid SS, Farooqui B, Rizvi Q, Sultana T, Siddiqui AA: Risk of transmission and features of hepatitis C after needlestick injuries. Infect Control Hosp Epidemiol 1999, 20:63-64.
3. Chung H, Kudo M, Kumada T, Katsushima S, Okano A, Nakamura T, Osaki Y, Kohigashi K, Yamashita Y, Komori H, Nishiuma S: Risk of HCV transmission after needlestick injury, and the efficacy of short-duration interferon administration to prevent HCV transmission to medical personnel. J Gastroenterol 2003, 38:877-879.

[Alix00]

CDC stated recently that the rick of getting hep.C is 1.8% and can range up to 10% ,factors that make it high up to 10% is the bore needles sticks and no gloves. still its doccumented by many studies over the pub med that the rick is low and not so common. but you have to be super carful in handling that virus bcz low % does not mean no infection and remeber preventioin is the best treatment.

[alagirl]

I was an acute patient, and I had VERY high antibody levels already at 7 - 8 weeks after my exposure.  At the outside, if you aren't positive at three months, I wouldn't worry.

[YuK]

2007 post

[alagirl]

oy!  Good catch - didn't see that.

[becksta29]

A stick injury is different indeed,no1 should say a needle stick injury is the same as swirting the virus directly into ur veins,but yes still a chance to catch the virus with a ***** of a dirty needle but the odds of that happening are a lot less that the transfusion and injecting it i have heard around 5% but depending on different circumstances.
i personally know 3 people in my home town who did not catch it from a needle stick injury.
-1 was a nurse,she had gloves on,and by her own fault she pricked herself whilst giving pt insulin shot...she put the lid back on the syringe and it went thru the lid so she had gloves and a lid protecting her,but she is trained to put the needles into the sharps containers not put the lid on it afterwards so thats why it was her fault.
The other 2 were just careless drug users.1 got pricked by some1 walkin into them with there syringe..hence he had a thick jumper on.The other pricked himself on his girlfreinds syringe while he was trying to help her inject herself,i actually think he had gloves on too(not sure) cos he new she had hepc and he would have been extra careful knowing that.
I would be extra careful even if u have gloves on or not cos,there is a risk but just not as high as the injecting and transfusions etc.
im pretty sure iv heard and read that 6 months is the waiting period after a exposure...but maybe some are longer i dont know,id get tested even after a yr if it was me just to be sure cos but thats just me.goodluck...hope u dont have it