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Prevention of the healthcare worker-to-patient HBV, HCV, HIV transmission

The transmission of a hematogenous virus from a medical professional to a patient is an exceptional occurrence. The risk depends on the type of treatment performed, the compliance with standard precautions and the plasma viral load in the infected healthcare worker. The main agents involved are the Hepatitis B (HBV) and Hepatitis C (HCV) viruses and the Human Immunodeficiency Virus (HIV). In September 2009, the Directorate General for Health referred the case to the High Council for Public Health so that it could update scientific advice on HCV and HIV spread by healthcare workers to patients, in complement with the Directorate General for Health request of August 2007 concerning the same issue for HBV.
In this report, the HCSP recommends :

  1. to prevent patients infection by following standard precautions and systematic HBV vaccination of healthcare workers;
  2. to identify infected healthcare workers by early diagnosis;
  3. to measure and reduce the viral load of infected healthcare workers;
  4. to propose a responsible approach to infected healthcare workers.

It also defends the setting up of a national commission that will assess the healthcare-associated virus transmission risk in order to centralize cases concerning infected healthcare workers in the hands of professionals able to assess individual situations. The essential role of this commission would consist in providing recommendations to the (future) healthcare professional on prevention issues and rule on any necessity to restrict his or her professional work. This opinion will be consultative, it would not be opposable.

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