3
Definitions
Table 3. Categorization of Healthcare-Associated
Procedures According to Level of Risk for
Bloodborne Pathogen Transmission
Category I:
Procedures with negligible risk of bloodborne virus transmission
• Regular history-taking and/or physical or dental examinations, including gloved
oral examination with a mirror and/or tongue depressor and/or dental explorer and
periodontal probe
• Routine dental preventive procedures (e.g., application of sealants or topical fluoride
or administration of prophylaxis
a
), diagnostic procedures, orthodontic procedures,
prosthetic procedures (e.g., denture fabrication), cosmetic procedures (e.g., bleaching )
not requiring local anesthesia
• Routine rectal or vaginal examination
• Minor surface suturing
• Elective peripheral phlebotomy
b
• Lower gastrointestinal tract endoscopic examinations and procedures, such as
sigmoidoscopy and colonoscopy
• Hands-off supervision during surgical procedures and computer-aided remote or
robotic surgical procedures
• Psychiatric evaluations
c
Table 2. 2020 Viral Load Thresholds for Any Restrictions on
HCP Practice
Note: e issue of viral nucleic acid quantification for HBV, HCV, and HIV remains
challenging because different assay methodologies provide differing results. No uniform
agreement exists about the conversions of genome equivalents per milliliter (GE/mL) to
international units for HBV, HCV, or HIV.
• For HBV, 1,000 IU, using the World Health Organization (WHO) conversion for
GE/mL to international units (5 GE/mL = 1 IU/mL). This threshold, which was
arbitrarily set in the SHEA 2010 guidance at 10
4
GE/mL has now been modified to
1,000 IU (i.e., ~5 × 10
3
GE/mL), consonant with the Canadian guidelines.
1
• For HCV: 'HCV RNA undetectable' (i.e., implying a sustained virologic response
(SVR), or cure). Effective, and most often curative, therapy is now available.
• For HIV: 'suppressed viral RNA.' In the United States, viral suppression typically
means an HIV viral load <200 copies/mL. Suppressive therapy is now widely
available.
