Title
Management of Healthcare Personnel with Hepatitis B, Hepatitis C, or HIV in US Healthcare Institutions
Authoring Organization
Publication Month/Year
October 13, 2020
Last Updated Month/Year
October 11, 2024
Supplemental Implementation Tools
Document Type
Consensus
External Publication Status
Published
Country of Publication
US
Document Objectives
Here, we examine progress in the management of bloodborne pathogens and how 10 years’ experience and the medical advances described above necessitate a change in the recommendations made in the 2010 SHEA guideline.1 It updates the expert guidance presented in the previous 3 SHEA documents and attends to issues that were not addressed directly in the prior SHEA documents.
Target Patient Population
Healthcare personnel living with hepatitis B, hepatitis C, or human immunodeficiency virus
PICO Questions
What factors contribute to the pathogenesis and risk for transmission of HIV, HCV, and HBV from HCP to patients?
Given the medical progress made in the treatment or cure of these viral infections over the past decade, what modifications for determining viral load thresholds for any restrictions on HCP practice are advisable? Should these thresholds, if any, consider fluctuations in viral loads (“blips”) that are known to occur?
Should institutions continue to characterize procedures as category II or III, or should these procedures be called “exposure-prone procedures”? How should they be managed?
What are academic institutions’ and professional schools’ responsibilities for education, training, and management of students and trainees regarding the prevention of HCP-to-patient transmission of bloodborne pathogens?
What policies and procedures should institutions have in place to provide guidance to HCP living with HBV, HCV, and/or HIV?
Should a patient who has an exposure to an HCP with a viral load that is undetectable (ie, HBV, HCV, or HIV) receive postexposure prophylaxis and/or follow-up?
Should the management recommendations be altered if an HCP living with HBV, HCV, and/or HIV with a previously undetectable viral load becomes substantially immunocompromised due to a concurrent comorbidity or therapy?
When an HCP, student, or trainee who is living with a bloodborne pathogen moves to another institution, what are the responsibilities of both the HCP and the institution to assure that this information is shared with the receiving institution?
How should institutions provide guidance for HCP living with HBV?
How should institutions manage HCP living with HCV?
How should institutions provide guidance for HCP living with HBV?How should institutions provide guidance for HCP living with HIV?
Have expert review panels been effective in providing oversight for HCP living with HBV, HCV, and/or HIV? How should oversight panels be assembled and how should they function?
Inclusion Criteria
Male, Female, Adolescent, Adult, Child, Infant, Older adult
Health Care Settings
Ambulatory, Emergency care, Hospital, Long term care, Outpatient, Operating and recovery room
Intended Users
Epidemiology infection prevention, nurse, nurse practitioner, physician, physician assistant
Scope
Management, Prevention
Diseases/Conditions (MeSH)
D017325 - Hepatitis B Vaccines, D006282 - Health Personnel
Keywords
human immunodeficiency virus (HIV), hepatitis C, hepatitis B, HBV, HIV/AIDS, HIV, HCV, vaccines, healthcare workers, healthcare personnel
Source Citation
Henderson DK, Dembry LM, Sifri CD, Palmore TN, Dellinger EP, Yokoe DS, Grady C, Heller T, Weber D, Del Rio C, Fishman NO, Deloney VM, Lundstrom T, Babcock HM. Management of healthcare personnel living with hepatitis B, hepatitis C, or human immunodeficiency virus in US healthcare institutions. Infect Control Hosp Epidemiol. 2020 Oct 14:1-9. doi: 10.1017/ice.2020.458. Epub ahead of print. PMID: 33050959.