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PubMed1992

Comparison of female to male and male to female transmission of HIV in 563 stable couples. European Study Group on Heterosexual Transmission of HIV.

OBJECTIVE: To identify risk factors for heterosexual transmission of HIV and to compare the efficiency of male to female and female to male transmission. DESIGN: Cohort study of heterosexual couples. Regular partners of HIV infected subjects were tested and both members of the couples interviewed every six months. HIV prevalence in partners was analysed according to the characteristics of the couples. SETTING: Nine European countries. SUBJECTS: 563 couples comprising 156 female index patients with their 159 male partners and 400 male index patients with their 404 female partners. Partners reporting risk factors other than sexual contacts with the index patient were excluded. MAIN OUTCOME MEASURES: HIV infection in partners and high risk sexual behaviour. RESULTS: Overall, 19 (12%) male partners and 82 (20%) female partners were infected with HIV, suggesting that male to female transmission is 1.9 (95% confidence interval 1.1 to 3.3) times more effective than female to male transmission. An advanced stage of HIV infection in the index patient (odds ratio 17.6; 4.9 to 62.7) and sexual contacts during menses (3.4; 1.0 to 11.1) increased the risk of female to male transmission and stage of infection (2.7; 1.5 to 4.9), anal sex (5.1; 2.9 to 8.9), and age of the female partner (3.9; 1.2 to 13.0 for age > 45 years) increased the risk of male to female transmission. None of the 24 partners who had used condoms systematically since the first sexual contact was infected. CONCLUSIONS: Several factors which potentiate the risk of transmission through unprotected vaginal intercourse have been identified. Knowledge of these factors could be helpful for counselling patients infected with HIV and their sexual partners.

Adolescent↗
PubMedDate not supplied

Determinant factors for malaria transmission on the coast of Oaxaca State, the main residual transmission focus in Mexico.

OBJECTIVE: The purpose of this study was to investigate the influence of demographic, socioeconomic and ecological factors in malaria transmission in the most important residual transmission focus in Mexico, located in the state of Oaxaca. MATERIAL AND METHODS: The extension of the focus was determined by a spatial and time analysis of the distribution of malaria cases in the state between 1998 and 1999 using a Geographical Information System. A malaria transmission intensity index (MTII) was constructed based on the total number of cases during the study period and the duration and frequency of transmission outbreaks within the villages. The relationship between local determinants and malaria transmission intensity was investigated using multinomial and ordered logistic models. RESULTS: The distribution of villages according to their MTII was: 325 high, 341 medium, 142 low and 717 with no transmission. Localities of high MTII were associated with areas having a tropical climate with summer rains and low water evaporation. Most high MTII villages were located in elevations between 200 and 500 m above sea level, in the area around Pochutla City. The amount of temporary streams in the neighborhood of localities had a highly significant positive association with the MTII. Distance to roads was only significant in the high malaria MTII stratum. CONCLUSIONS: The main factors determining malaria transmission in the focus are related to good conditions for the breeding of mosquito vectors. The existence of short-range population movements around Pochutla, the main economically active city in the area, indicates the necessity to implement a system of epidemiological surveillance to halt the dispersion of new outbreaks.

Humans↗
PubMed2005

Relative efficiency of biological transmission of Anaplasma marginale (Rickettsiales: Anaplasmataceae) by Dermacentor andersoni (Acari: Ixodidae) compared with mechanical transmission by Stomoxys calcitrans (Diptera: Muscidae).

Anaplasma marginale Theiler is a tick-borne intraerythrocytic rickettsial pathogen of cattle that also can be mechanically transmitted by biting flies. Rickettsemia during the acute phase of infection may reach as high as 10(9) infected erythrocytes (IEs) per milliliter of blood. Animals that survive acute infection develop a life-long persistent infection that cycles between 10(2.5) and 10(7) IE/ ml of blood. We compared stable fly Stomoxys calcitrans (L.) -borne mechanical transmission during acute infection with Rocky Mountain wood tick, Dermacentor andersoni Stiles-borne biological transmission in the persistent phase of infection to demonstrate quantitatively that biological transmission by ticks is considerably more efficient than mechanical transmission by biting flies. Stable flies that partially fed on an acutely infected calf and were immediately transferred to susceptible calves to complete their bloodmeals failed to transmit A. marginale. Ticks that fed on the original acquisition host after it reached the persistent phase of infection (>300-fold lower rickettsemia) successfully transmitted A. marginale after transfer to the same calves that failed to acquire infection after fly feeding. Failure of fly-borne mechanical transmission at a rickettsemia >300-fold higher than that from which ticks transmit with 100% efficiency demonstrates that tick-borne biological transmission is at least 2 orders of magnitude more efficient than direct stable fly-borne mechanical transmission.

Anaplasma marginale↗
PubMed1991

A mathematical model for Plasmodium vivax malaria transmission: estimation of the impact of transmission-blocking immunity in an endemic area.

We have developed a multi-state mathematical model to describe the transmission of Plasmodium vivax malaria; the model accommodates variable transmission-blocking/enhancing immunity during the course of a blood infection, a short memory for boosting immunity, and relapses. Using the model, we simulated the incidence of human malaria, sporozoite rates in the vector population, and the level of transmission-blocking immunity for the infected population over a period of time. Field data from an epidemiological study conducted in Kataragama in the south of Sri Lanka were used to test the results obtained. The incidence of malaria during the study period was simulated satisfactorily. The impact of naturally-acquired transmission-blocking immunity on malaria transmission under different vectorial capacities was also simulated. The results show that at low vectorial capacities, e.g., just above the threshold for transmission, the effect of transmission-blocking immunity is very significant; however, the effect is lower at higher vectorial capacities.

Animals↗
PubMed1997

Increased vertical transmission of human immunodeficiency virus from hepatitis C virus-coinfected mothers. Women and Infants Transmission Study.

To determine if hepatitis C virus (HCV) infection affects vertical transmission of human immunodeficiency virus (HIV), 487 HIV-infected pregnant women in the prospective, multicenter, Women and Infants Transmission Study had HCV antibody (anti-HCV by second-generation ELISA) and HCV RNA (by quantitative polymerase chain reaction) measured in peripartum maternal plasma; 161 (33%) were anti-HCV-positive. HIV vertical transmission occurred from 42 HCV-infected mothers (26.1%) versus 53 HCV-uninfected mothers (16.3%; odds radio [OR], 1.82; P = .01). In a logistic regression model that included maternal drug use, a potential confounder, HCV infection was marginally associated with perinatal HIV transmission (OR, 1.64; P = .05), whereas drug use was not. Women who transmitted HIV had higher levels of HCV RNA (median, 721,254 copies/mL) than those who did not (337,561 copies/mL; P = .01). Maternal HCV infection is associated with increased HIV vertical transmission. Further studies are needed to ascertain if HCV directly affects perinatal HIV transmission or is a marker for another factor, such as maternal drug use.

Adult↗
PubMed1997

The effect of maternal viral load on the risk of perinatal transmission of HIV-1. New York City Perinatal HIV Transmission Collaborative Study Group.

OBJECTIVE: To determine the effect of maternal viral load at delivery on the risk of perinatal transmission of HIV-1. DESIGN: A nested case-control study within a prospectively followed cohort of HIV-1-infected pregnant women and their infants. SETTING: The multicenter New York City Perinatal HIV Transmission Collaborative Study. PARTICIPANTS: Fifty-one women who gave birth to HIV-1 infected infants were frequency-matched within CD4+ cell count quintiles with 54 non-transmitting mothers. MAIN OUTCOME MEASURES: Maternal quantity of HIV-1 viral RNA was assayed in plasma obtained near delivery using the nucleic acid sequence-based amplification assay system. RESULTS: Viral RNA was detected in 73 (70%) out of 105 women and the median viral load was 16,000 RNA copies/ml in transmitters and 6,600 in non-transmitters (P < 0.01). When adjusted for maternal CD4+ count near delivery, women with measurable viral load were nearly sixfold more likely to transmit HIV-1 than women with viral load below detection [adjusted odds ratio (AOR), 5.8; 95% confidence interval (CI), 2.2 15.5]. The odds ratio for perinatal transmission of log10 viral load, adjusted for CD4 count was 2.7 (95% CI, 1.5-5.1). When stratified by the stage of HIV-1 disease, the only group with significant association between log10 viral load and transmission were AIDS-free women with CD4+ count > 500 x 10(6)/l (AOR, 9.1; 95% CI, 2.6-31.5). CONCLUSIONS: High maternal viral load increases the likelihood of perinatal transmission of HIV-1 in women without AIDS and advanced immunosuppression. HIV-1 infected pregnant women without advanced disease, shown by others to have the lowest risk of perinatal transmission, may benefit the most from efforts to identify and decrease viral load at delivery.

Adult↗
PubMed2004

Effect of bird-to-bird transmission of the West Nile virus on the dynamics of the transmission of this disease.

Two recent publications report that direct bird-to-bird transmission of West Nile virus is possible. The effect of a bird-to-bird transmission on the transmission dynamics of this virus is studied through mathematical modeling. The model still treats the bird-to-mosquito-to-bird as the main transmission route. The results of numerical calculations show that there are changes in the dynamics of the transmission of West Nile fever in humans when the non-mosquito transmission route becomes more important.

Animals↗
PubMed2004

[Distribution and timing of antibody to SARS-CoV in SARS cases of transmission chain or non-transmission chain].

BACKGROUND: To find out the timing of serologic responses after illness onset and distribution of IgG antibody to SARS-CoV in SARS cases of transmission chain or non-transmission chain. METHODS: The IgG and IgM antibodies to SARS-CoV were tested by indirect ELISA in serum samples from 301 clinically diagnosed SARS cases. RESULTS: Totally 158 SARS cases were involved in 15 chains of transmission. The positive rates of SARS-CoV IgG in those chains were 85.70%-100.00% and the overall rate was 94.30% (149/158). The chain of transmission could spread to four generations, but the SARS cases were reduced with increase of generations. There was no significant difference among positive rates of SARS-CoV IgG for generations, Chi square=5.11, P greater than 0.05. The positive rate of SARS-CoV IgG in cases who were not in chain of transmission was 12.59%(18/143) which was statistically significantly different from that of cases in chain of transmission, Chi square=199.64, P less than 0.001. During days 0-7,8-14,15-21,22-30 after onset, the cumulated positive rate of SARS-CoV IgG was 16.67%, 40.00%, 70.00% and 93.10%, respectively, then was kept at the level above 90% and lasted for 217 days. The cumulated positive rate of SARS-CoV IgM during days 0-7 after onset was the same to that of IgG. During days 8-14, 55.17% of cases had seroconversion for IgM which reached a peak (86.96%) during days 21-30. Then the rate rapidly declined. CONCLUSION: More than 94% of cases with SARS could produce IgG antibody when they were infected by SARS-CoV. Detecting SARS-CoV IgG could provide a diagnostic evidence for case confirmation. SARS-CoV IgG appeared as early as 7 days after onset and reached the peak at about weeks 4. Then the high rate of antibody was maintained for more than 6 months.

Antibodies, Viral↗
PubMed2004

Quantitative assessment of truncal FDG-PET examination with postinjection transmission scan--comparison with preinjection transmission scan.

UNLABELLED: The purpose of this study was to assess the quantitative accuracy of truncal FDG PET with a postinjection transmission scan. METHODS: Ten subjects with lung cancer were recruited for this study. Prior to the emission scan, a transmission scan was performed for 10 min. All subjects received 370 MBq of intravenous administration of FDG prior to a 60-min emission scan. Immediately following the emission scan, a postinjection transmission scan was performed. Emission data from 40 to 60 min postinjection were reconstructed with either pre- or postinjection transmission data and converted to a standardized uptake value (SUV) image. On each SUV image, 5 regions of interest were placed and regions of interest on the SUV image with a postinjection transmission scan (SUVpost) were plotted against those with preinjection transmission (SUVpre), and a regression line was generated. Using the slope and Y-intercept of the regression line, percent error of estimation of the SUV was calculated based on the following equation: % error = ISUVpre - SUVpostI x 100/SUVpre. RESULTS: In the low SUV area (SUV = 1), the averaged percent error was 9.4 +/- 12.0% (mean +/- SD), whereas in the high SUV area (SUV = 10), the averaged percent error was 2.8 +/- 3.1%. The least percent error was 1.8 +/- 1.8% (SUV = 3.8) in this study. CONCLUSION: In the study on truncal FDG PET with postinjection transmisson scan, the quantitative accuracy was preserved and the method is clinically available.

Aged↗
PubMed1997

Simultaneous emission transmission tomography using technetium-99m for both emission and transmission.

This phantom study investigates whether attenuation maps from transmission data degraded by increased noise from subtraction of emission counts can still provide useful attenuation correction in the regular and obese chest. Technetium-99m was used for both emission and transmission on a triple head simultaneous emission transmission tomography (Tc-Tc SETT) system. Fanbeam transmission counts were computed by subtracting emission counts estimated from the two parallel collimator heads. Radioactive decay was used to simulate organ counts from injections of 900 and 400 MBq sestamibi for regular and obese chest sizes. Line source activity was 350 MBq. Control attenuation maps were obtained with no emission activity. Noise control included catering for negative and zero transmission counts, pre-filtering and segmentation of mu maps. Pre-filtering was tried before and after subtraction and before and after setting negative pixels to zero. Mean+/-SD count/pixel at the heart in anterior transmission projections was typically 33+/-18 for the regular and 1+/-7 for the obese chest. For the obese chest, pre-filtering before resetting negative counts best preserved mean mu in soft tissue and lung. Tc-Tc SETT mu mean+/-SD for the regular chest were 0.144+/-0.012 and 0.058+/-0.004 for soft tissue and lung and for the obese chest, 0.152+/-0.075 and 0.059+/-0.017. The accuracy of the Tc-Tc SETT bullseye plots for the regular chest was the same as with control map attenuation correction and 3 times better than with no correction. For the obese chest it was as good as with control map correction only if mu map segmentation was applied. Tc-Tc SETT soft tissue and lung mu in 28 patient studies indicated that segmentation is practical for a wide range of chest sizes. Tc-Tc SETT on a triple-head system offers an accurate, inexpensive method of attenuation correction for the majority of chest sizes.

Humans↗
PubMed2006

Limited BVDV transmission and full protection against CSFV transmission in pigs experimentally infected with BVDV type 1b.

Bovine viral diarrhea virus (BVDV) in pigs may interfere with the detection and epidemiology of classical swine fever virus (CSFV). To investigate the importance of BVDV infections in pigs, first we studied the transmission dynamics of a recent BVDV field isolate. Subsequently, the protection of BVD antibodies against transmission and clinical disease of CSF virus was studied. Only limited transmission of BVDV occurred (R = 0.20), while no CSFV transmission occurred in pigs with BVDV antibodies. We concluded that BVDV transmission among pigs is possible, but seems to be limited and thus the virus should disappear from a population if no new introductions occur. Furthermore, the presence of BVD antibodies may completely prevent the transmission of CSFV and therefore could protect pigs against classical swine fever. It was also noticed that double infections with BVDV and CSFV were incorrectly diagnosed using the neutralization peroxidase linked assay (NPLA), which is the golden standard for antibody detection. This might hamper the diagnosis of CSF in herds with a high BVD prevalence.

Animals↗
PubMedDate not supplied

Onchocerca ochengi transmission dynamics and the correlation of O. ochengi microfilaria density in cattle with the transmission potential.

The intensity of natural transmission of Onchocerca ochengi and Onchocerco volvulus by anthropo-boophilic Simulium damnosum s.l. was studied longitudinally in two cattle watering sites of a cattle ranch within a predominantly cattle populated area of the Guinea savanna of Cameroon and related to cattle O. ochengi skin microfilaria abundance. During the 12 months study period, a total of 4696 flies was individually dissected to examine the monthly transmission potential (MTP) of O. ochengi and O. volvulus. The estimated Simulium damnosum s.l. annual biting rates (ABR) on human baits were 47529 flies at the bank of the Vina "du sud" river. The ABR at the lake, which was situated at about 2 km upland from the perennial river, was 8579. The monthly parous rate was highly correlated with monthly biting rate. The annual transmission potentials (ATP) of O. ochengi were calculated to be 7732 and 1669 at the riverbank and the lake, respectively. Transmission occurred mainly in the dry season, peaking in the months of January to mid-March when dermal microfilaria density in the animals was also the highest. The O. ochengi microfilaria uptake by the fly vectors was host microfilaria density-dependent. The MTP of O. ochengi was positively correlated with dermal microfilaria density. The mean number of microfilariae per fly taken up during a blood meal was high during the dry season as was the mean number of infective larvae per fly but declined significantly with the onset of the early rains. A similar seasonality of transmission was also observed for O. volvulus that was concurrently transmitted by the same vector flies, but its ATP was comparatively much lower: 1332 infective larvae per man per year at the riverbank and 107 around the lake. The population dynamics of cattle microfilariae therefore plays an important role in the regulation of O. ochengi transmission.

Animals↗
PubMed2006

Plasmid pSci6 from Spiroplasma citri GII-3 confers insect transmissibility to the non-transmissible strain S. citri 44.

The insect-transmissible strain GII-3 of Spiroplasma citri contains plasmids pSci1-6, five of which (pSci1-5) encode adhesin-like proteins and one (pSci6) encodes protein P32, which has been associated with insect transmissibility. In contrast, S. citri strains ASP-1 and 44, which cannot be transmitted via injection into the leafhopper vector Circulifer haematoceps, lack these proteins and also do not carry plasmids pSci1-6. To further study the apparent relationship between the presence of plasmids and insect transmissibility, plasmids from S. citri GII-3 were introduced into the insect-non-transmissible S. citri strain 44 by electrotransformation using the tetM gene as the selection marker. Tetracycline-resistant transformants were shown to carry one, two or three distinct plasmids. Plasmids pSci1-6 were all detected in the transformants, pSci1 being the most frequently found, alone or together with other plasmids. Selected S. citri 44 transformants having distinct plasmid contents were submitted, separately or in combination, to experimental transmission to periwinkle (Catharanthus roseus) plants via injection into the leafhopper vector. The occurrence of symptomatic plants indicated that, in contrast to S. citri 44, spiroplasmal transformants were transmitted to the host plant, in which they multiplied. Spiroplasma cultures isolated from these infected plants all contained pSci6, leading to the conclusion that, under the experimental conditions used, transformation by pSci6 conferred insect transmissibility to S. citri strain 44. This is believed to be the first report of a phenotypic change associated with transformation of S. citri by natural plasmids.

Adhesins, Bacterial↗
PubMed2005

Interchannel nonlinear transmission penalties in polarization-multiplexed 2 x 10 Gbit/s differential phase-shift keying transmission.

We discuss the performance of a multichannel 2 x 10 Gbit/s polarization-multiplexed differential phase-shift keying transmission system. Through simulations and transmission experiments we find that, despite the constant power envelope of non-return-to-zero phase-shift keying modulation formats, polarization multiplexing strongly reduces the nonlinear tolerance and transmission performance at a 2 x 10 Gbit/s line rate with multichannel transmission. This results in a 10 dB power penalty when comparing single- and nine-channel transmission. Additionally, multichannel impairments in differential phase-shift keying and on-off keying are compared for 2 x 10 Gbit/s polarization-multiplexed transmission.

Journal Article↗
PubMed2006

[Transmission and non-transmission portable ECG in home care medicine].

Portable electrocardiography is advantageous in that patients can record ECG by themselves at any time and place. Portable ECG can be classified into two kinds of devices, transmission type and non-transmission type. By using transmission-type portable ECG, patients can obtain an ECG diagnosis from the center by transmitting the recorded ECG. Transmission-type portable ECG is extremely useful for patients needing emergency treatment for such as an attack of ischemic heart disease or arrhythmic event. On the other hand, a patient has to go to a specialist to obtain an ECG diagnosis with the non-transmission-type portable ECG device after recording the ECG alone. As this model is slightly cheaper, and is easy to use, the non-transmission-type portable ECG is good in non-emergency use for early diagnosis and prevention of cardiac disease. Portable ECG is useful for ECG monitoring over time without seeing the patient, not only for symptomatic analysis of the patient. For example, silent myocardial ischemia and arrhythmic events developing during exercise will become clear in periodical portable ECG recording. In particularly, portable ECG is useful for noncontinual ECG monitoring of patients with Brugada syndrome and those administered with antiarrhythmic drugs. Portable ECG increases the opportunity to discover cardiac disease from the aspect of preventive medicine. When patients use a portable ECG during exercise, they can understand whether the exercise is suitable for their heart. Portable ECG is a useful measurement in preventive medicine as described above, not only for the home care of patients.

Electrocardiography↗
PubMed1994

Antiretroviral treatment of men infected with human immunodeficiency virus type 1 reduces the incidence of heterosexual transmission. Italian Study Group on HIV Heterosexual Transmission.

OBJECTIVE: To determine the incidence of heterosexual human immunodeficiency virus type 1 disease transmission and the effect of zidovudine therapy on this risk of transmission. DESIGN: A cohort of 436 monogamous seronegative female sexual partners of human immunodeficiency virus type 1-infected males was followed up for 740 person-years with regular structured interviews and laboratory tests. PATIENTS: At enrollment of the women, 50% of their infected partners had one or more signs of disease progression (symptoms of acquired immunodeficiency syndrome, p24 antigen positivity, or CD4+ cell counts lower than 0.4 x 10(9)/L) and 15% were treated with zidovudine. MAIN OUTCOME MEASURE: Incidence rates of seroconversion were calculated and relative risks were estimated as incidence rate ratios. RESULTS: Twenty-seven women seroconverted during follow-up, and the incidence of seroconversion was 3.7 per 100 person-years. Seroconversion was about six times more frequent (relative risk, 5.8; 95% confidence interval, 2.2 to 15.3) in couples not using condoms. Men with signs of disease progression transmitted infection to their partners more frequently and were more frequently treated with zidovudine. When the risk of transmission was estimated accounting for disease progression, the rate of transmission in zidovudine-treated men was lower than in untreated men (relative risk, 0.5; 95% confidence interval, 0.1 to 0.9). CONCLUSION: Treatment of human immunodeficiency virus type-1 infected men with zidovudine reduces, but does not eliminate, heterosexual transmission of infection. Behavioral counseling that encourages sexual practices with a lower risk of transmission remains the most important method of prevention.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Multicenter trial on mother-to-infant transmission of GBV-C virus. The Lombardy Study Group on Vertical/Perinatal Hepatitis Viruses Transmission.

Evidence indicates that the GBV-C or hepatitis G virus can cause persistent infection in humans, but little is known on the importance of vertical transmission. To assess the risk of mother-to-infant transmission and the clinical outcome of infected babies, we investigated 175 anti-HCV positive mothers and followed-up their children for 3-33 months. GBV-C RNA was detected by RT-PCR and anti-E2 antibody was assayed by EIA. Thirty-four (19.4%) women were GBV-C RNA positive and transmission occurred to 21 (61.8%) babies; 20 (95.2%) acquired GBV-C alone, and one (4.8%) GBV-C and HCV. Maternal factors such as intravenous drug use, HIV coinfection, HCV-RNA positivity, and type of feeding were not correlated with GBV-C transmission. GBV-C RNA remained persistently positive in all infected babies but one baby who seroconverted to anti-E2. Seven (35%) babies with GBV-C alone developed marginally elevated ALT; the baby with HCV and GBV-C co-infection had the highest ALT peak value (664 IU/l). Seven of the 141 (5%) babies born to the GBV-C RNA negative mothers acquired HCV and six (85.7%) had abnormal ALT. The mean ALT peak value was significantly higher (P < 0.05) for babies with HCV than for those with GBV-C. None of the children with GBV-C or with HCV became icteric. GBV-C is frequently present in anti-HCV positive women. The infection is transmitted efficiently from mother to baby and rate of transmission is much higher than that for HCV. GBV-C can cause persistent infection in babies but usually without clear evidence of liver disease.

Adult↗
PubMed2003

Risk of HCV transmission after needlestick injury, and the efficacy of short-duration interferon administration to prevent HCV transmission to medical personnel.

BACKGROUND: We carried out this study to assess the risk of hepatitis C virus (HCV) transmission after needlestick injuries in medical personnel, and to evaluate the efficacy of short-duration interferon administration to prevent HCV transmission. METHODS: A total of 684 personnel who had been occupationally exposed to an anti-HCV-positive source and followed for more than 3 months were retrospectively examined. RESULTS: Of the 684 subjects, 279 (41%) were treated with 1 to 3 days of interferon either just after or 1 to 12 days after the injury. One case of HCV infection was found in each of the treated (1/279; 0.4%) and nontreated (1/405; 0.2%) groups. There was no significant difference in the transmission of HCV between the two groups. Both infected patients were treated with interferon after developing acute hepatitis, and HCV was subsequently cleared. CONCLUSIONS: There is a lower risk of HCV transmission after needlestick accident than previously reported, and short-duration interferon administration at an early stage after the needlestick injury, to prevent HCV transmission, is unnecessary.

Antiviral Agents↗