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Centers for Disease Control and Prevention, in collaboration with the
Hospital Infection Control Practices Advisory Committee, has issued
recommendations for follow-up of health care workers after occupational
exposure to hepatitis C virus (Hepatitis C Virus).
The recommendations were published in the July 4, 1997, issue of
Morbidity and Mortality Weekly Report.
Health care workers are at occupational risk for acquiring this
infection because Hepatitis C Virus is transmitted by direct percutaneous exposure to
The CDC recommends that individual health care institutions consider
establishing policies and procedures for follow-up of infection with Hepatitis C Virus
after percutaneous or permucosal exposures to blood.
For the source, baseline testing for anti-Hepatitis C Virus.
For the person exposed to an anti-Hepatitis C Virus-positive source, baseline and
follow-up (e.g., six months) testing for anti-Hepatitis C Virus and alanine
Confirmation by supplemental anti-Hepatitis C Virus testing of all anti-Hepatitis C Virus results
reported as repeatedly reactive by enzyme immunoassay.
Recommending against post-exposure prophylaxis with immune globulin or
anti-viral agents (interferon).
Education of health care workers about the risk for and prevention of
bloodborne infections in occupational settings, with the information
routinely updated to ensure accuracy.
The CDC report notes that follow-up studies of health care workers who
sustained a percutaneous exposure to blood from an anti-Hepatitis C Virus-positive
patient have reported an average incidence of seroconversion after
unintentional needlesticks or sharps exposures of 1.8 percent.
In the absence of post-exposure prophylaxis, the CDC report lists six
issues that need to be considered in defining a protocol for follow-up.
These are: (1) limited data about the occupational risk of transmission,
(2) limitations of available serologic testing for detecting infection
and determining infectivity, (3) poorly defined risk for transmission by
sexual and other exposures, (4) limited benefit of therapy for chronic
disease, (5) cost of follow-up, and (6) medical and legal implications.