A physician with a positive hepatitis C virus RNA test after a needlestick injury

Needlestick accidents continue to be a hazard for healthcare workers. We report the development of acute hepatitis C infection in a physician after needlestick injury. Hepatitis C virus (HCV)-RNA, seroconversion and a raised plasma alanine aminotransferase (ALAT) level were found in plasma three months after the accident. Treatment with interferon alfa and ribavirin was started. While the physician was on treatment, HCV-RNA test results from plasma taken the day treatment was started became available. HCV-RNA was undetectable by quantitative bDNA assay, undetectable by qualitative polymerase chain reaction (PCR) and undetectable by transcription mediated amplification (TMA). A dilemma arose at this point: should the patient stop the treatment or continue the planned therapy? The physician decided to continue a 24-week course of treatment. Six months after the end of treatment, the physician was still HCV-RNA-negative and with a normal plasma ALAT level. The rationale of the decision to continue therapy is discussed. This information may be useful for clinicians confronted with a similar dilemma.