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The 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 blood.
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 aminotransferase activity.
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.