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J Thorac Cardiovasc Surg 2009;137:519-520
© 2009 The American Association for Thoracic Surgery

Editorial

Acute hepatitis C virus and cardiac surgeons

Cardiovascular and Thoracic Surgery, CVT Surgical Center, Baton Rouge, LA

Received for publication November 17, 2008; accepted for publication November 19, 2008.

^_* Address for reprints: R. Scott Thurston, MD, FACS, Cardiovascular and Thoracic Surgery, CVT Surgical Center, 7777 Hennessy, Baton Rouge, LA 70808. (Email: sthurston2003@yahoo.com).

The first 20% of the full text of this article appears below.

The experience of having acquired hepatitis C virus (HVC) in the operating room as a practicing cardiovascular surgeon has led me to review the literature and to try and define the proper treatment and subsequently the social implications and options related to resuming practice as quickly as possible. Below is what I have gleaned from the literature and my own experience in the hope of providing recommendations for the surgical community.

Hepatitis C virus is a worldwide problem with an estimated 170 million people infected, including 1.4% of the US population. It can lead to cirrhosis and liver cancer in the minority (20%) of patients.¹ The prevalence is as high as 22% in Egypt and averages 3% in China. The incidence in the United States has been declining steadily, and approximately 20,000 cases are now thought to occur per year.² No vaccine is available. Seroconversion or illness with acute HCV in a practicing surgeon has legal, ethical, and personal considerations, as transmission from surgeon to a patient is well documented.

Hepatitis C virus was discovered and named in 1989. Before this it was known as "non A non B hepatitis." It is unrelated to hepatitis A or B virus. It is a single-stranded RNA virus that at 50 nm is smaller than the wavelength of light. It is 9400 base pairs long, and the coding regions for the 3 structural and 7 nonstructural viral proteins are known. The virus occurs in 6 major genotypes with more than 80 subtypes. The genotypes occur in specific geographic regions of the human population. The only host is the human . . . [Full Text of this Article]

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Acute hepatitis C virus and the cardiac surgeon: An explanation needed

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J. Thorac. Cardiovasc. Surg. 2009 138: 1038. [Extract] [Full Text] [PDF]

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				K. Olsen, P. E. Dahl, E. J. Paulssen, A. Husebekk, A. Widell, and R. Busund Increased Risk of Transmission of Hepatitis C in Open Heart Surgery Compared With Vascular and Pulmonary Surgery Ann. Thorac. Surg., November 1, 2010; 90(5): 1425 - 1431. [Abstract] [Full Text] [PDF]

				C.-A. Mestres Acute hepatitis C virus and the cardiac surgeon: An explanation needed. J. Thorac. Cardiovasc. Surg., October 1, 2009; 138(4): 1038 - 1038. [Full Text] [PDF]