Weekly releases (1997–2007) - Volume 6, Issue 34, 22 August 2002

The Department of Health in England has issued new guidance on the management of hepatitis C infected healthcare workers (1,2). Previous guidance in the United Kingdom (UK) recommended that healthcare workers infected with hepatitis C should be restricted from undertaking exposure prone procedures (EPPs) only if they had been associated with transmission of infection to a patient (3). Since these recommendations were made, however, there have been five documented incidents in England and Wales (4-8), one in Spain (9), and two in Germany (10,11) in which infected healthcare workers have transmitted hepatitis C infection to patients during EPPs.

The transmission of HIV from patient to healthcare worker in an occupational setting was first documented in 1984 (1). In countries that have surveillance and HIV testing systems to recognise occupationally acquired cases, over 100 cases of HIV transmission after an occupational exposure were reported worldwide up to June 1999 (2). Antiretroviral drugs are used for post-exposure prophylaxis (PEP), and zidovudine alone is said to reduce transmission of HIV by 81% (3), but failures of PEP have been documented (4). The European Commission has recently funded a project to develop guidelines for the standardised management of occupational exposures to HIV/bloodborne infections and evaluation of PEP in Europe. The EuRoPEP (European Registry of Post-Exposure Prophylaxis) project is coordinated by the Istituto Nazionale per le Malattie Infettive, Lazzaro Spallanzani, Rome, and involves a group of expert representatives from Croatia, Denmark, France, Germany, Italy, Portugal, Spain, Switzerland, and the United Kingdom. The group presented two abstracts at the XIV International AIDS Conference in Barcelona, Spain (7-12 July 2002, http://www.aids2002.com/). The first assessed current policies and practice for the management of occupational exposures and PEP (5); the second aimed to provide a set of recommendations based on a review of national management strategies as discussed during a consensus meeting (6), and copies are available on request: ([email protected]).