Infection with hepatitis C virus (HCV) is a matter of great concern because of its potentially grave consequences. Instead of relying on the conventional anti-HCV antibody test to detect HCV
infection after
needlestick incidents, we used the polymerase chain reaction (PCR) to achieve earlier detection, to manage a patient more effectively, and to exclude possible
infection more quickly. Fourteen incidents were studied in which the source patients were positive for both the anti-HCV antibody and HCV
RNA, and the exposed subjects were negative for anti-HCV antibody at the time of the incidents. In one of the exposed subjects, a nurse, the result of the PCR test for HCV
RNA was positive at 2 wk after the
needlestick incident; the nurse's viral load was very low (800 copies/ml) and she responded well to immediate medical treatment. She never developed acute
hepatitis C; her serum anti-HCV antibody level and
alanine aminotransferase (ALT) activity did not become elevated, and results of her PCR test for HCV
RNA were negative following treatment. In the other 13
needlestick incidents, the results of PCR tests of the exposed subjects were negative for HCV
RNA throughout the study and possible
infections were quickly ruled out.