Guidance on the investigation and management of occupational exposure to hepatitis C. PHLS Advisory Committee on Blood Borne Viruses.

This document updates previous PHLS guidance on the risks and management of occupational exposure to hepatitis C. In line with recent guidance from the UK Health Departments, the PHLS now recommends that all source patients, subject to appropriate consent, should be tested for evidence of hepatitis C infection. A baseline serum should be obtained from the exposed health care worker and stored for at least two years. Health care workers exposed to known infected sources should be followed up at six, 12, and 24 weeks after exposure. Serum taken at six and 12 weeks should be tested for hepatitis C virus (HCV) RNA and serum taken at 12 and 24 weeks for anti-HCV. Health care workers exposed to a source believed not to be infected do not require active follow up for hepatitis C unless requested or if they develop symptoms or signs of liver disease. Management of personnel exposed to a source whose hepatitis C status is unknown or a source unavailable for testing will depend upon a risk assessment by a designated doctor. Health care workers who are found to be positive for HCV RNA or antibody to hepatitis C should be referred to an appropriate consultant for consideration of early treatment.