May 31, 2015
What topics should be discussed with patients who have HCV infection?
What should HCV-infected persons be advised to do to protect their livers from further harm?
Should HCV-infected persons be restricted from working in certain occupations or settings?
CDC's recommendations for prevention and control of HCV infection specify that persons should not be excluded from work, school, play, child care, or other settings on the basis of their HCV infection status. There is no evidence of HCV transmission from food handlers, teachers, or other service providers in the absence of blood-to-blood contact.
What is the risk for HCV infection from a needlestick exposure to HCV-contaminated blood?
After a needlestick or sharps exposure to HCV-positive blood, the risk of HCV infection is approximately 1.8% (range: 0%-10%).
Other than needlesticks, do other exposures, such as splashes to the eye, pose a risk to health care personnel for HCV transmission?
Although a few cases of HCV transmission via blood splash to the eye have been reported, the risk for such transmission is expected to be very low. Avoiding occupational exposure to blood is the primary way to prevent transmission of bloodborne illnesses among health care personnel. All health care personnel should adhere to Standard Precautions . Depending on the medical procedure involved, Standard Precautions may include the appropriate use of personal protective equipment (e.g., gloves, masks, and protective eyewear).
What follow-up testing is recommended for health care personnel exposed to HCV-positive blood?
Should HCV-infected health care personnel be restricted in their work?
There are no CDC recommendations to restrict a health care worker who is infected with HCV. The risk of transmission from an infected health care worker to a patient appears to be very low. All health care personnel, including those who are HCV positive, should follow strict aseptic technique and Standard Precautions, including appropriate hand hygiene, use of protective barriers, and safe injection practices.
Should pregnant women be routinely tested for anti-HCV?
No. Since pregnant women have no greater risk of being infected with HCV than non-pregnant women and interventions to prevent mother-to-child transmission are lacking, routine anti-HCV testing of pregnant women is not recommended. Pregnant women should be tested for anti-HCV only if they have risk factors for HCV infection.
What is the risk that an HCV-infected mother will spread HCV to her infant during birth?
Approximately 6 of every 100 infants born to HCV-infected mothers become infected with the virus. Transmission occurs at the time of birth, and no prophylaxis is available to prevent it. The risk is increased by the presence of maternal HCV viremia at delivery and also is 2-3 times greater if the woman is coinfected with HIV. Most infants infected with HCV at birth have no symptoms and do well during childhood. More research is needed to find out the long-term effects of perinatal HCV infection.
Should a woman with HCV infection be advised against breastfeeding?
No. There is no evidence that breastfeeding spreads HCV. However, HCV-positive mothers should consider abstaining from breastfeeding if their nipples are cracked or bleeding.
When should children born to HCV-infected mothers be tested to see if they were infected at birth?
Children should be tested for anti-HCV no sooner than age 18 months because anti-HCV from the mother might last until this age. If diagnosis is desired before the child turns 18 months, testing for HCV RNA could be performed at or after the infant's first well-child visit at age 1-2 months. HCV RNA testing should then be repeated at a subsequent visit, independent of the initial HCV RNA test result.
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