{"id":1757,"date":"2003-10-01T01:00:00","date_gmt":"2003-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/hepatite-aigue-c-apres-piercing-un-mode-exceptionnel-de-contamination\/"},"modified":"2018-10-20T18:39:30","modified_gmt":"2018-10-20T16:39:30","slug":"hepatite-aigue-c-apres-piercing-un-mode-exceptionnel-de-contamination","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/hepatite-aigue-c-apres-piercing-un-mode-exceptionnel-de-contamination\/","title":{"rendered":"HEPATITE AIGUE C APRES PIERCING : UN MODE EXCEPTIONNEL \nDE CONTAMINATION ?"},"content":{"rendered":"

2003<\/strong><\/p>\n

Denis GRASSET, Corinne BORDERES, Miguel CARREIRO, Florian BUSATO, Jean-Louis PAYEN, Christian SEIGNEURIC. Service de M\u00e9decine Interne – Centre Hospitalier G\u00e9n\u00e9ral, 100 Rond Point L\u00e9on Cladel \u2013 BP 765 \u2013 82013 MONTAUBAN C\u00e9dex.<\/em><\/p>\n

H\u00e9patologie <\/strong>– \u00a02000-03-09 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Les modes de contamination du virus de l’hepatite C (VHC) restent inconnus dans environ 30 % des cas; ce sont dans ces situations que d’autres types de transmission en particulier nosocomiales ou per-cutan\u00e9es ont \u00e9t\u00e9 \u00e9voqu\u00e9es ,principalement dans des enqu\u00eates \u00e9pid\u00e9miologiques.<\/p>\n

Nous rapportons l’observation d’une femme de 69 ans, sans ant\u00e9c\u00e9dent notable chez laquelle avait \u00e9t\u00e9 r\u00e9alis\u00e9e une s\u00e9rologie de l’h\u00e9patite C lors d’un bilan syst\u00e9matique en 1996. En janvier 2000, elle pr\u00e9sentait un tableau associant un sub-ict\u00e8re,des urines fonc\u00e9es et des c\u00e9phal\u00e9es .Les tests biologiques retrouvait une cytolyse et une chol\u00e9stase (ALAT \u00e0 42 N, ASAT \u00e0 20 N, phosphatases alcalines \u00e0 3 N ; gamma GT \u00e0 20 N ; bilirubine \u00e0 80 \u00b5mol\/l). Le bilan \u00e9tiologique complet d’h\u00e9patopathie \u00e9tait n\u00e9gatif except\u00e9 l’h\u00e9patite C pour laquelle la s\u00e9rologie \u00e9tait positive ; la PCR qualitative positive et le g\u00e9notype 2. Le diagnostic d’h\u00e9patite aigu\u00eb C \u00e9tait retenu et la patiente \u00e9tait trait\u00e9e par INTERFERON ALFA 2 B sous-cutan\u00e9e 3 millions d’unit\u00e9s 3 fois par semaine pendant 3 mois avec une n\u00e9gativation de la PCR,d\u00e8s le premier mois et des tests biologiques se normalisant en 2 mois. La PCR (amplicor Roche )restait negative 6 mois apr\u00e8s l’arr\u00eat du traitement .Cependant ,18 mois plus tard ,il apparaissait de nouveau une discr\u00e8te augmentation des ALAT \u00e0 1,3 fois la normale et une PCR qualitative positive ,conduisant \u00e0 la r\u00e9alisation d’une ponction biopsie h\u00e9patique retrouvant des l\u00e9sions class\u00e9es A2 FO dans le score METAVIR.
\nL’interrogatoire pr\u00e9cis de cette patiente ne retrouvait aucun facteur favorisant connu d’h\u00e9patite C notamment pas d’entourage porteur d’h\u00e9patite C, pas de soin dentaire, d’acupuncture ou de geste invasif ou d’intervention r\u00e9cente. Par contre, elle avait fait un mois avant l’\u00e9pisode d’h\u00e9patite aigu\u00eb un piercing dans les lobes des oreilles qui nous para\u00eet \u00eatre le mode de contamination de cette h\u00e9patite aigue.<\/p>\n

Le piercing est une pratique de modification corporelle de plus en plus d\u00e9velopp\u00e9 ces derni\u00e8res ann\u00e9es et concerne un public tr\u00e8s vari\u00e9 .Les infections virales li\u00e9es \u00e0 ce geste sont rares, des observations d’h\u00e9patite B ont \u00e9t\u00e9 d\u00e9crits de fa\u00e7on exceptionnelle ,mais \u00e0 ce jour aucun cas d’h\u00e9patite C. Seules les \u00e9tudes \u00e9pid\u00e9miologiques tendent \u00e0 montrer un sur-risque li\u00e9 au piercing et cela de fa\u00e7on inconstant. Par ailleurs ,le traitement chez notre patiente \u00e9tait probablement insuffisant et la rechute tardive plus d’1 an apr\u00e8s l’arret de celui ci est \u00e0 noter.<\/p>\n

En conclusion, la pratique \u00e9tendue du piercing par des professionnels de plus en plus nombreux doit inciter \u00e0 une campagne nationale d’information des usagers et veiller \u00e0 l’am\u00e9lioration des pratiques professionnelles de piercing m\u00eame banales dans le lobe de l’oreille, pouvant \u00eatre un des modes de transmission des h\u00e9patites sans cause reconnue et doit \u00eatre recherch\u00e9e en cas d’h\u00e9patite aigu\u00eb C comme dans notre observation.<\/p>\n","protected":false},"excerpt":{"rendered":"

2003 Denis GRASSET, Corinne BORDERES, Miguel CARREIRO, Florian BUSATO, Jean-Louis PAYEN, Christian SEIGNEURIC. Service de M\u00e9decine Interne – Centre Hospitalier G\u00e9n\u00e9ral, 100 Rond Point L\u00e9on Cladel \u2013 BP 765 \u2013 82013 MONTAUBAN C\u00e9dex. H\u00e9patologie – \u00a02000-03-09 –\u00a0CO – ________________________________ Les modes de contamination du virus de l’hepatite C (VHC) restent inconnus dans environ 30 % […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[14],"class_list":["post-1757","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-14"],"yoast_head":"\nHEPATITE AIGUE C APRES PIERCING : UN MODE EXCEPTIONNEL DE CONTAMINATION ? - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/hepatite-aigue-c-apres-piercing-un-mode-exceptionnel-de-contamination\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HEPATITE AIGUE C APRES PIERCING : UN MODE EXCEPTIONNEL DE CONTAMINATION ? 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