Hepatitis C Virus (HCV)

Immune globulin (IG) and antiviral agents are not recommended for PEP after exposure to HCV-positive blood or OPIM.4 In addition, no guidelines exist for the treatment of acute HCV infection. However, limited data indicate that antiviral therapy might be beneficial when initiated early in the course of an acute HCV infection.4 Recommendations for postexposure evaluation and follow-up (Table 2) are intended to achieve early diagnosis of HCV infection.

Table 2. Recommendations for follow-up subsequent to exposure to the HCV.4
Source person
  • Testing for anti-HCV*
Exposed person
  • If the source person is anti-HCV negative
    • Baseline testing or further follow-up of the exposed person is not necessary
  • If source person is anti-HCV positive
    • Baseline testing
      • for anti-HCV* and ALT (a liver enzyme) activity
    • Follow-up testing
      • for HCV RNA in 4-6 weeks
      • for anti-HCV* and ALT (a liver enzyme) activity in 4-6 months
*Confirm all anti-HCV-positive results by enzyme immunoassay using recombinant immunoblot assay (RIBA™)

Expert counseling is recommended for HCP exposed to the HCV, especially in cases of known or suspected pregnancy, breastfeeding, or serious medical illnesses. Additional information should be provided on any special precautions to prevent secondary transmission of the HCV during the follow-up period, current information on how to modify sexual practices and strategies to prevent pregnancy, and on donating blood, plasma, organs, tissue, or semen.4

No modifications of patient-care responsibilities are necessary based solely on an exposure to HCV-positive blood or OPIM.4 If an exposed person becomes acutely infected with the HCV, the person should be evaluated according to published recommendations for infected healthcare providers. Those who are chronically infected with the HCV should ensure adherence to the principles of Standard and Transmission-based Precautions and all other recommendations.6,7