There are two major circumstances concerning HCV transmission and healthcare workers. One is the risk of a healthcare worker with HCV infection transmitting the infection to a patient, and the other is the risk of a patient with HCV infection transmitting the infection to the healthcare worker. The risk of transmission of HCV in either direction is low.
Transmission risk to patients from healthcare workers may arise during exposure prone procedures. The Centers for Disease Control and Prevention in the USA have estimated that the risk of HCV infection after a needlestick or sharps injury to be less than 2%.54 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 recently published new guidelines regarding the testing of health professionals and the settings in which healthcare workers might need to limit performing exposure prone procedures (Australian national guidelines for the management of healthcare workers living with blood borne viruses and healthcare workers who perform exposure prone procedures at risk of exposure to blood borne viruses).55 Any testing, counselling and follow-up performed in that context should be done in accordance with this Policy.
As for all tests where testing of a healthcare worker is undertaken, confidentiality must be maintained.
Healthcare workers who are exposed or potentially exposed to blood-borne viruses should have access to testing and counselling in their practice, institution or through specialist referral: they should not be required to request or perform tests on themselves. 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.