New guidance from CDC for clinical management of HCP exposed to HCV

The CDC developed new recommendations for testing algorithms and clinical management of health care personnel with the possibility of occupational exposure to hepatitis C, according guidance from Morbidity and Mortality Weekly Report.

“A source patient or [health care personnel (HCP) ]found to be positive for HCV RNA should be referred to care,” Anne C. Moorman, MPH, from the division of viral hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, and colleagues wrote. “Postexposure prophylaxis of hepatitis C is not recommended for HCP who have occupational exposure to blood and other body fluids.”

The CDC recommends the source patient and HCP should undergo baseline testing within 48 hours after exposure to HCV. Two test options recommended for the source patient include the nucleic acid test (NAT) for HCV RNA or test source patient for antibodies to HCV (anti-HCV). If the source patient is positive for antibodies, then they should be tested for HCV RNA.

“Follow-up testing of health care personnel (HCP) is recommended if the source patient is HCV RNA positive, anti-HCV positive with RNA status unknown, or cannot be tested,” the authors wrote.

The HCP may be tested simultaneously with the source patient.

According to the CDC, follow-up testing may be recommended based on the status of the source patient.

At 3 to 6 weeks postexposure, the HCP should be tested with a nucleic acid test for HCV RNA. If HCV RNA is negative at this time, the CDC recommends a final test for anti-HCV at 4 to 6 months postexposure.

“[CDC] now recommends additional follow-up testing at 4 to 6 months for anti-HCV with reflex or follow-up HCV RNA if anti-HCV positive because of the possibility of intermittent periods of aviremia during acute HCV infection,” Moorman and colleagues wrote.