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➤ Establish an oversight panel for appropriate tracking and
management of any HCP who conduct Category III/exposure-prone
procedures and is identified as living with HBV, HCV, and/or HIV.
➤ Institutions should have a defined protocol for managing patient
exposures to HCP blood or other potentially infectious fluids.
➤ For exposures to blood or other potentially infectious fluids from
an HCP with HIV, even if the viral load is undetectable, this plan
should include notifying the patient about the exposure and offering
post-exposure chemoprophylaxis, following current post-exposure
prophylaxis recommendations.
➤ Importantly, if the HCP has an undetectable viral load, in which case
the risk for transmission is likely vanishingly small, post-exposure
prophylaxis should be administered out of an abundance of caution.
➤ HCP who had HCV and who have been treated with direct-acting
antivirals (DAA) and are cured present no risk for transmission.
➤ Management of potential hepatitis B or hepatitis C exposures should
follow current CDC recommendations.
➤ The management of a recently immunocompromised HCP living with
HBV, HCV, and/or HIV should be individualized, and the individual
should be monitored more closely (i.e., with more frequent viral load
testing) for possible reversion to higher viral loads.
➤ When an HCP living with a bloodborne pathogen who conducts
exposure-prone procedures moves to a new institution, the
individual HCP has the responsibility of notifying the new
institution's occupational medicine physician or, alternatively, may
grant permission for their current oversight panel to inform the
occupational medicine physician at the receiving institution.
• With the concurrence of the HCP, this communication can often be facilitated/
coordinated by the hospital epidemiologist or occupational medicine office.
• Once at the new institution, the HCP living with a bloodborne pathogen should
assist with the establishment of an oversight as described below.
➤ When students living with bloodborne pathogens move into training
programs, the responsibility for notifying the new institution or
training program lies with the individual student, with the support
and assistance of the oversight panel.
