Hepatitis C virus: guidance on the risks and current management of occupational exposure. PHLS Hepatitis Subcommittee
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Healthcare workers exposed to Hepatitis C virus (HCV) need follow-up testing at six months. Routine initial testing or immunoglobulin prophylaxis is not currently recommended for preventing HCV infection.
Area of Science:
- Occupational health
- Infectious diseases
- Virology
Background:
- Hepatitis C virus (HCV) transmission is a documented risk following percutaneous exposure to infected blood in healthcare settings.
- Healthcare workers (HCWs) are at risk of occupational exposure to bloodborne pathogens, including HCV.
Purpose of the Study:
- To define appropriate follow-up protocols for healthcare workers following potential exposure to Hepatitis C virus.
- To evaluate the efficacy and necessity of routine anti-HCV testing and prophylactic measures post-exposure.
Main Methods:
- Review of documented cases of HCV transmission in healthcare workers.
- Analysis of serological follow-up data for HCWs after percutaneous or mucocutaneous exposures.
- Evaluation of current recommendations for post-exposure management.
Main Results:
- Follow-up of HCWs with significant percutaneous or mucocutaneous exposures to potentially HCV-infected sources is recommended.
- Serum storage from the source and anti-HCV testing of the HCW at six months post-exposure are advised.
- Routine initial anti-HCV testing of the HCW and routine use of human normal immunoglobulin for prophylaxis are not recommended.
Conclusions:
- A six-month follow-up period with serological testing is the recommended strategy for managing HCWs after potential Hepatitis C virus exposure.
- Current evidence does not support routine immediate post-exposure testing or prophylactic immunoglobulin administration for HCV.
- Testing of source blood with unknown HCV status is not routinely justified.
Abstract:
Hepatitis C virus (HCV) transmission after percutaneous exposure to blood at work has been documented. Follow up of health care workers who report significant percutaneous or mucocutaneous exposures to sources that are known to be, or that might be, HCV-infected should include storage of serum from the source (if identifiable) and anti-HCV testing of the blood specimen obtained from the health care worker at six months post-exposure. Routine testing of the health care worker's initial post-exposure specimen for anti-HCV is not recommended at present, nor is the routine use of human normal immunoglobulin as prophylaxis against HCV infection. Routine anti-HCV testing of blood specimens obtained from identifiable sources of unknown HCV status is not at present justified.