CDC updates recommendations for HBV management

The Centers for Disease Control and Prevention (CDC) recently updated its 1991 recommendations for the management of hepatitis B virus (HBV)-infected healthcare providers and students to prevent HBV transmission to patients.

“The primary goal of this report is to promote patient safety while providing risk management and practice guidance to HBV-infected healthcare providers and students, particularly those performing exposure-prone procedures such as certain types of surgery,” wrote Scott D. Holmberg, MD, of the Division of Viral Hepatitis, and colleagues.

They added that HBV infection alone should not disqualify infected healthcare practitioners from practice or study in their medical field and the updated guidelines offer recommendations on prevention strategies, ethical considerations, and recommendations for the chronically infected. The guidelines include the following updates:

• No pre-notification of patients of a healthcare provider's or student's HBV status

• Use of HBV DNA serum levels rather than hepatitis B e-antigen status to monitor infectivity

• For those healthcare professionals requiring oversight, specific suggestions for composition of expert review panels and threshold value of serum HBV DNA considered "safe" for practice (<1,000 IU/mL).

The CDC reviewed the literature since the 1991 recommendations were published, finding no additional studies beyond what they were already aware of, the organization reviewed all hepatitis B outbreak investigations conducted by CDC and state officials since 1991 to gather data on HBV transmission. They focused on reports of acute HBV infection related to recent healthcare services as well as reports of HBV-infected providers being dismissed from their roles.