CDC recommendations for HCV exposure follow-up

The Centers for Disease Control and Prevention will soon issue new recommendations for hepatitis C virus that are summarized as follows1:

* No post-exposure prophylaxis is available for HCV -- immune globulin is not recommended.

* Institutions should provide health care workers with accurate and up-to-date information on the risk and prevention of all bloodborne pathogens, including HCV.

* Institutions should consider implementing policies and procedures for follow-up of health care workers after percutaneous or per-mucosal exposure to anti-HCV-positive blood.

* Such policies might include baseline testing of the source for anti-HCV and baseline and six-month follow-up testing of the person exposed for anti-HCV and ALT [alanine aminotransferase] activity. All anti-HCV results reported as repeatedly reactive by enzyme immunoassay should be confirmed by supplemental anti-HCV testing.

* There are currently no recommendations regarding restriction of health care workers with HCV. The risk of transmission from an infected worker to a patient appears to be very low. Furthermore, there are no serologic assays that can determine infectivity, nor are there data to determine the threshold concentration of virus required for transmission.

* As recommended for all health care workers, those who are anti-HCV positive should follow strict aseptic technique and standard (universal) precautions, including appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments.

Reference

1. Centers for Disease Control and Prevention. Issues and Answers: What is the risk of acquiring hepatitis C for health care workers and what are the recommendations for prophylaxis and follow-up after occupational exposure to hepatitis C virus? Hepatitis Surveillance Report no. 56. Atlanta; 1996 [in press]. *