The risk of transmission of hepatitis C from an HCV RNA positive health worker to other health workers or people, or from an HCV RNA positive person to health workers, is very low. Transmission risk between people with hepatitis C and healthcare workers may arise during exposure-prone procedures. The Centers for Disease Control and Prevention in the USA has estimated that the risk of hepatitis C after a needlestick or sharps injury from an HCV RNA positive person is less than 2%.62 Other exposures involving mucous membrane or splash injuries are probably lower risk than percutaneous injuries. Individual health service providers have developed their own diagnostic algorithms for testing healthcare workers who have undergone a blood or body fluid exposure. In general, they recommend confirming HCV viraemia in the exposure source, and following up the recipient for up to 3 months after exposure for the detection of HCV antibodies.
The Communicable Diseases Network Australia published guidelines regarding the testing of health professionals and the settings in which healthcare workers might need to limit performing exposure-prone procedures.84 Any testing, counselling and follow-up performed in that context should be done in accordance with these guidelines.
As for all tests where testing of a healthcare worker is undertaken, confidentiality must be maintained and support provided.
Healthcare workers who are exposed to hepatitis C, or experience a potential exposure incident, should be supported by their practice or institution to access testing, counselling, and specialist referral. Healthcare workers who are known to be living with blood-borne viruses should be in the care of their own medical practitioner and should not initiate diagnostic or monitoring tests on themselves.