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Olga Kalinina Saint-Petersburg Pasteur Institute

Tracing nosocomial HCV infection. Olga Kalinina Saint-Petersburg Pasteur Institute. Transmisson route of Viral Hepatitis. Transmission route. HAV. HBV. HCV. HDV. HEV. Food-Borne. Fecal-Oral. Water-Borne. Nosocomial. IVDU. Transfusion. Hemodialysis. Sexual. Household. Mother to

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Olga Kalinina Saint-Petersburg Pasteur Institute

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  1. Tracing nosocomial HCV infection Olga Kalinina Saint-Petersburg Pasteur Institute

  2. Transmisson route of Viral Hepatitis Transmission route HAV HBV HCV HDV HEV Food-Borne Fecal-Oral Water-Borne Nosocomial IVDU Transfusion Hemodialysis Sexual Household Mother to new born Common Infrequent Never

  3. 1. Nosocomial transmission of hepatitis C virus in one state hospital Patientsinvolved in HCV outbreak *ITN – intratraheal narcosis

  4. Suspected time of patients involving 1. Nosocomial transmission of hepatitis C virus in one state hospital

  5. 1. Nosocomial transmission of hepatitis C virus in one state hospital Laboratory resultsfor patients and hospital staff involved in the outbreak

  6. 496 St. Petersburg 498 St. Petersburg 100 497 St. Petersburg 499 St. Petersburg 500 St. Petersburg Patients and physician involved in outbreak 501 St. Petersburg 309 St. Petersburg HPCRNA HPVHCVN HPCGENOM HC16362 HCD85516 MD8-2 HCU01214 783 St. Petersburg 735 St. Petersburg CJTB 643 St. Petersburg HCV-N S62220 CJ483 HC-J4 789 St. Petersburg 728 St. Petersburg J33 K1-S3 641 St. Petersburg 685 St. Petersburg 576 St. Petersburg 204 St. Petersburg HCVPOLYP HCV-AD78 761 St. Petersburg HPCY1B-6 U89019 185 St. Petersburg 788 St. Petersburg 779 St. Petersburg 704 St. Petersburg 615 St. Petersburg HD-1 687 St. Petersburg b 648 St. Petersburg 100 747 RF2k_1b St. Petersburg 796 RF2k_1b St. Petersburg 1 700 St. Petersburg 732 St. Petersburg 100 MD1-2 MD5-1 a HPCGAA 98 PH77CV CHCJ1 785 St. Petersburg HPCP1 0.1 1. Nosocomial transmission of hepatitis C virus in one state hospital Phylogenetic analysis of the HCV strains performed on 300 nucleotides within the NS5B region using Neighbor-Joining method with GBV-B virus as outgroup. Bootstrap values are given on the branches as percentage from 500 replicas. These results indicate that all patients and the anesthesiologist were infected by the same HCV strain

  7. 1. Nosocomial transmission of hepatitis C virus in one state hospital • The available epidemiological evidence and the phylogenetic results suggested that the anesthesiologist was the source of transmission

  8. 2. Nosocomial transmission of hepatitis C virus in dialisis units Origin and laboratory results for 152 patients included in the study

  9. 2. Nosocomial transmission of hepatitis C virus in dialisis units Subtype distribution in HCV strains from dialysis units

  10. HCV-BK Japan189 Unit 2195 Unit 2IADB-250 Ireland105 Unit 1 110 Unit 1 160 Unit 1 122 Unit 1 134-NS Unit 1 117 Unit 1 172-NS Unit 1 154-NS Unit 1 146 Unit 1 115 Unit 1 129-NS Unit 1 165 Unit 1 118 Unit 1 116 Unit 1 140-NS Unit 1 120 Unit 1 148-NS Unit 1 99 Phylogenetic analysis of the HCV strains belonged to genotype 1b performed on 300 nucleotides within the NS5B region using Neighbor-Joining method with GBV-B virus as outgroup. Bootstrap values are given on the branches as percentage from 500 replicas 74 14 93 204 Unit 2 178 Unit 2 196 Unit 2 182 Unit 2 132-NS Unit 1 104 Unit 1 185 Unit 2 203 Unit 2 111 Unit 1 183 Unit 2 308 Unit 3 310 Unit 3 323-NS Unit 3 317-NS Unit 3 212-NS Unit 2 177 Unit 2 112 Unit 1 150-NS Unit 1 197 Unit 2 309 Unit 3 100 97 88 67 53 67 100

  11. A B c d e 1 HCV-BK Japan189 unit-2195 unit-2iadb-250 Ireland 105 unit-1 110 unit-1 160 unit-1 122 unit-1 134-NS unit-1 117 unit-1 172-NS unit-1 154-NS unit-1 146 unit-1 115 unit-1 129-NS unit-1 165 unit-1 118 unit-1 116 unit-1 140-NS unit-1 120 unit-1 148-NS unit-1 190 unit-2 709 IVDU 728 IVDU c d e 2 c d e 1b 3 c d e 74 4 93 c d e 5 c d e 6 c d e 7 2. Nosocomial transmission of hepatitis C virus in dialisis units Phylogenetic relations between 17 HCV strains from patients at Unit 1 and the schematic distribution of the patients on dialysis machines (1-7) and in the shifts (A: Monday, Wednesday, Friday; B: Tuesday, Thursday, Saturday; c- morning, d – day, e – evening)

  12. 2. Nosocomial transmission of hepatitis C virus in dialisis units • Phylogenetic analysis of HCV strains isolated in hemodialysis units has shown that patients were infected by the HCV strains which may have been circulating since long on such settings • There was no evidence for recent introduction by e.g. blood products

  13. Acknowledgements Sergey Mukomolov St. Petersburg Pasteur Institute Lars O Magnius Swedish Institute for Infectious Disease Control Helene Norder Konstantin Zhdanov Medical Military Academy, St. Petersburg Denis Gusev Timophei Vetrov St. Petersburg Pavlov Medical University

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