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 Previous Article

Clinical Microbiology Reviews, July 2003, p. 546-568, Vol. 16, No. 3
0893-8512/03/$08.00+0     DOI: 10.1128/CMR.16.3.546-568.2003

Managing Occupational Risks for Hepatitis C Transmission in the Health Care Setting

David K. Henderson*

Warren G. Magnuson Clinical Center, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland 20892

Hepatitis C virus (HCV) infection is a significant contemporary health problem in the United States and elsewhere. Because it is primarily transmitted via blood, hepatitis C infection presents risks for both nosocomial transmission to patients and occupational spread to health care workers. Recent insights into the pathogenesis, immunopathogenesis, natural history, and treatment of infection caused by this unique flavivirus provide a rationale for the use of new strategies for managing occupational hepatitis C infections when they occur. This article reviews this developing information. Recently published data demonstrate success rates in the treatment of "acute hepatitis C syndrome" that approach 100\%, and although these studies are not directly applicable to all occupational infections, they may provide important clues to optimal management strategies. In addition, the article delineates approaches to the prevention of occupational exposures and also addresses the difficult issue of managing HCV-infected health care providers. The article summarizes currently available data about the nosocomial epidemiology of HCV infection and the magnitude of risk and discusses several alternatives for managing exposure and infection. No evidence supports the use of immediate postexposure prophylaxis with immunoglobulin, immunomodulators, or antiviral agents. Based on the very limited data available, the watchful waiting and preemptive therapy strategies described in detail in this article represent reasonable interim approaches to the complex problem of managing occupational HCV infections, at least until more definitive data are obtained.

* Mailing address: Building 10, Room 2C 146, 9000 Rockville Pike, Bethesda, MD 20892. Phone: (301) 496-3515. Fax: (301) 402-0244. E-mail: dkh{at}nih.gov.

Clinical Microbiology Reviews, July 2003, p. 546-568, Vol. 16, No. 3
0893-8512/03/$08.00+0     DOI: 10.1128/CMR.16.3.546-568.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Kagan, I., Lee Ovadia, K., Kaneti, T. (2008). Physicians' and Nurses' Views On Infected Health Care Workers. Nurs Ethics 15: 573-585 [Abstract]  
  • Williams, S., Libotte, V., Ramsay, M. (2007). Compliance with follow-up after occupational exposure to hepatitis C. Occup Med (Lond) 57: 596-598 [Abstract] [Full Text]  
  • Elder, A., Paterson, C. (2006). Sharps injuries in UK health care: a review of injury rates, viral transmission and potential efficacy of safety devices. Occup Med (Lond) 56: 566-574 [Abstract] [Full Text]  


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