10
Management
HCP Living with HBV
➤ HCP living with HBV should seek an initial evaluation from a physician
who has expertise in HBV management to characterize the serologic
and virologic aspects of infection.
➤ HCP living with HBV should seek optimal medical management,
including, when appropriate, treatment with effective antiviral agents.
➤ HCP living with HBV who do not perform Category III/exposure-prone
procedures should not be prohibited from participating in patient-
care activities solely on the basis of their HBV infection.
➤ Consonant with the most recent set of guidelines from CDC
concerning the management of HCP living with HBV, there is no
justification for, nor benefit gained from, routine notification of
patients with regard to HCP living with HBV who are being managed
through the institution's oversight panel.
➤ For HCP living with HBV who perform Category III/exposure-prone
procedures:
a. HCP living with HBV and who, despite appropriate treatment, have
circulating viral loads ≥1,000 IUs should not perform Category III/exposure-
prone procedures.
b. HCP living with HBV whose circulating viral loads can be consistently
suppressed to <1,000 IUs can perform Category III/exposure-prone
procedures, as long as the individual:
i. has not been previously identified as having transmitted infection to
patients while on appropriate suppressive therapy
ii. obtains advice from the oversight panel (discussed in more detail below)
about recommended practices to minimize risk of exposure events
iii. is followed by a personal physician who has expertise in the management
of HBV infection and who is allowed by the HCP to participate in or
communicate with the oversight panel about the individual's clinical status
iv. is monitored on a periodic basis (e.g., every 6 months) to assure that the viral
load remains <1,000 IUs, with results shared with the oversight panel and
v. agrees, in writing, to follow the recommendations of the oversight panel.
