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CDC updates guide on hepatitis B virus-infected health providers, students

Atlanta—The Centers for Disease Control and Prevention July 6 offered new guidance on safe clinical practice for health providers and students who are infected with the hepatitis B virus.

“These new recommendations contain important information for our academic dental institutions as you address issues related to those providers and students who may be chronically infected with HBV,” said Dr. Richard Valachovic, executive director of the American Dental Education Association.

The CDC report is available at www.cdc.gov/mmwr.

The report updates the 1991 CDC recommendations on preventing the transmission of bloodborne viruses from infected health care provider to patients during exposure-prone invasive procedures. The new information reflects changes in the epidemiology of HBV infection in the United States and advances in the medical management of chronic HBV infection and policy directives issued by health authorities since 1991. The recommendations also explicitly address the issue of dental and medical students who are discovered to have chronic HBV infection.

For most chronically HBV-infected providers and students who conform to current standards for infection control, HBV infection status alone does not require any curtailing of their practices or supervised learning experiences, according to the CDC. The updated guide outlines criteria for safe clinical practice of HBV-infected providers and students that can be used by the appropriate occupational or student health authorities to develop their own institutional policies, or by an institutional expert panel that monitors providers who perform exposure-prone procedures.

The primary goal of this report is to promote patient safety while providing risk management and practice guidance to HBV-infected health care providers and students, particularly those performing exposure-prone procedures such as certain types of surgery. Because percutaneous injuries sustained by health care personnel during certain surgical, obstetrical and dental procedures provide a potential route of HBV transmission to patients as well as providers, this report emphasizes prevention of operator injuries and blood exposures during exposure-prone surgical, obstetrical and dental procedures.

These updated recommendations reaffirm the 1991 CDC recommendation that HBV infection alone should not disqualify infected persons from the practice or study of surgery, dentistry, medicine or allied health fields.