Acute hepatitis C virus infection in a nurse trainee following a needlestick injury

Hepatitis C virus (HCV) infection after biological accident (needlestick injury) is a rare event. This report describes the first case of acute HCV infection after a needlestick injury in a female nursing student at Padua University Hospital. The student nurse was injured on the second finger of the right hand when recapping a 23-gauge needle after taking a blood sample. The patient who was the source was a 72-year-old female with weakly positive anti-HCV test results. Three months after the injury, at the second step of follow-up, a relevant increase in transaminases with a low viral replication activity (350 IU/mL) was observed in the student, indicating HCV infection. The patient tested positive for the same genotype (1b) of HCV as the injured student. A rapid decline in transaminases, which was not accompanied by viral clearance, and persistently positive HCV-RNA was described 1 month later. Six months after testing positive for HCV, the student was treated with pegylated interferon plus ribavirin for 24 weeks. A rapid virological response was observed after 4 weeks of treatment, and a sustained virological response was evident 6 months after therapy withdrawal, confirming that the patient was definitively cured. Despite the favourable IL28B gene (rs12979860) CC- polymorphism observed in the patient, which is usually predictive of a spontaneous clearance and sustained virological response, spontaneous viral clearance did not take place; however, infection with this genotype was promising for a sustained virological response after therapy.