We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Occupational Transmission of Hepatitis C Virus—Reply

Mark S. Sulkowsky, MD; Stuart C. Ray, MD; David L. Thomas, MD
JAMA. 2002;288(12):1469-1471. doi:10.1001/jama.288.12.1469.
Text Size: A A A
Published online


In Reply: The data presented by Dr Jagger and colleagues suggest the rate of HCV transmission following percutaneous occupational exposure may be lower than previously recognized. It is difficult for us to fully evaluate several of the studies they cite, because most were not published in English. Still, heterogeneity in reported transmission risk is not surprising since so many factors influence transmission,such as the number of virions in the inoculum and the susceptibility of the exposed tissues. Available data suggest that virions must penetrate skin and that larger inocula are more infectious, as would be expected with exposure to hollow-bore needles containing blood from persons with a high serum HCV RNA level. Consequently, the overall risk of transmission from various investigations will vary according to the nature of the exposures studied. To a lesser extent, differences in ascertainment of HCV exposure and infection in studies of HCWs may also affect estimates of transmission risk. It is probably most useful to consider transmission risk according to at least 3 factors: whether the exposure was (1) via mucous membrane, intact skin, or percutaneous; (2) from a solid-bore or a hollow-bore needle, or (3) from blood with high, low, or undetectable HCV RNA levels. Further research is clearly needed to provide precise estimates in each of these categories. In the meantime, as Jagger et al point out, HCWs with all but percutaneous exposure to hollow-bore needles contaminated with HCV RNA–containing blood (or other deep inoculations) can be reassured that the risk of HCV infection is very low.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.