对可能暴露于丙型肝炎病毒的医护人员进行检测和临床管理 - 美国疾病预防控制中心指南,2020 年。

IF 33.7 1区 医学 Q1 Medicine
Anne C Moorman, Marie A de Perio, Ronald Goldschmidt, Carolyn Chu, David Kuhar, David K Henderson, Susanna Naggie, Saleem Kamili, Philip R Spradling, Stuart C Gordon, Mark B Russi, Eyasu H Teshale
{"title":"对可能暴露于丙型肝炎病毒的医护人员进行检测和临床管理 - 美国疾病预防控制中心指南,2020 年。","authors":"Anne C Moorman, Marie A de Perio, Ronald Goldschmidt, Carolyn Chu, David Kuhar, David K Henderson, Susanna Naggie, Saleem Kamili, Philip R Spradling, Stuart C Gordon, Mark B Russi, Eyasu H Teshale","doi":"10.15585/mmwr.rr6906a1","DOIUrl":null,"url":null,"abstract":"<p><p>Exposure to hepatitis viruses is a recognized occupational risk for health care personnel (HCP). This report establishes new CDC guidance that includes recommendations for a testing algorithm and clinical management for HCP with potential occupational exposure to hepatitis C virus (HCV). Baseline testing of the source patient and HCP should be performed as soon as possible (preferably within 48 hours) after the exposure. A source patient refers to any person receiving health care services whose blood or other potentially infectious material is the source of the HCP's exposure. Two options are recommended for testing the source patient. The first option is to test the source patient with a nucleic acid test (NAT) for HCV RNA. This option is preferred, particularly if the source patient is known or suspected to have recent behaviors that increase risk for HCV acquisition (e.g., injection drug use within the previous 4 months) or if risk cannot be reliably assessed. The second option is to test the source patient for antibodies to hepatitis C virus (anti-HCV), then if positive, test for HCV RNA. For HCP, baseline testing for anti-HCV with reflex to a NAT for HCV RNA if positive should be conducted as soon as possible (preferably within 48 hours) after the exposure and may be simultaneous with source-patient testing. If follow-up testing is recommended based on the source patient's status (e.g., HCV RNA positive or anti-HCV positive with unavailable HCV RNA or if the HCV infection status is unknown), HCP should be tested with a NAT for HCV RNA at 3-6 weeks postexposure. If HCV RNA is negative at 3-6 weeks postexposure, a final test for anti-HCV at 4-6 months postexposure is recommended. A source patient or HCP found to be positive for HCV RNA should be referred to care. Postexposure prophylaxis of hepatitis C is not recommended for HCP who have occupational exposure to blood and other body fluids. This guidance was developed based on expert opinion (CDC. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR Recommend Rep 2001;50[No. RR-11]; Supplementary Figure, https://stacks.cdc.gov/view/cdc/90288) and reflects updated guidance from professional organizations that recommend treatment for acute HCV infection. Health care providers can use this guidance to update their procedures for postexposure testing and clinical management of HCP potentially exposed to hepatitis C virus.</p>","PeriodicalId":51328,"journal":{"name":"Mmwr Recommendations and Reports","volume":"69 6","pages":"1-8"},"PeriodicalIF":33.7000,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8631757/pdf/","citationCount":"0","resultStr":"{\"title\":\"Testing and Clinical Management of Health Care Personnel Potentially Exposed to Hepatitis C Virus - CDC Guidance, United States, 2020.\",\"authors\":\"Anne C Moorman, Marie A de Perio, Ronald Goldschmidt, Carolyn Chu, David Kuhar, David K Henderson, Susanna Naggie, Saleem Kamili, Philip R Spradling, Stuart C Gordon, Mark B Russi, Eyasu H Teshale\",\"doi\":\"10.15585/mmwr.rr6906a1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Exposure to hepatitis viruses is a recognized occupational risk for health care personnel (HCP). This report establishes new CDC guidance that includes recommendations for a testing algorithm and clinical management for HCP with potential occupational exposure to hepatitis C virus (HCV). Baseline testing of the source patient and HCP should be performed as soon as possible (preferably within 48 hours) after the exposure. A source patient refers to any person receiving health care services whose blood or other potentially infectious material is the source of the HCP's exposure. Two options are recommended for testing the source patient. The first option is to test the source patient with a nucleic acid test (NAT) for HCV RNA. This option is preferred, particularly if the source patient is known or suspected to have recent behaviors that increase risk for HCV acquisition (e.g., injection drug use within the previous 4 months) or if risk cannot be reliably assessed. The second option is to test the source patient for antibodies to hepatitis C virus (anti-HCV), then if positive, test for HCV RNA. For HCP, baseline testing for anti-HCV with reflex to a NAT for HCV RNA if positive should be conducted as soon as possible (preferably within 48 hours) after the exposure and may be simultaneous with source-patient testing. If follow-up testing is recommended based on the source patient's status (e.g., HCV RNA positive or anti-HCV positive with unavailable HCV RNA or if the HCV infection status is unknown), HCP should be tested with a NAT for HCV RNA at 3-6 weeks postexposure. If HCV RNA is negative at 3-6 weeks postexposure, a final test for anti-HCV at 4-6 months postexposure is recommended. A source patient or HCP found to be positive for HCV RNA should be referred to care. Postexposure prophylaxis of hepatitis C is not recommended for HCP who have occupational exposure to blood and other body fluids. This guidance was developed based on expert opinion (CDC. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR Recommend Rep 2001;50[No. RR-11]; Supplementary Figure, https://stacks.cdc.gov/view/cdc/90288) and reflects updated guidance from professional organizations that recommend treatment for acute HCV infection. Health care providers can use this guidance to update their procedures for postexposure testing and clinical management of HCP potentially exposed to hepatitis C virus.</p>\",\"PeriodicalId\":51328,\"journal\":{\"name\":\"Mmwr Recommendations and Reports\",\"volume\":\"69 6\",\"pages\":\"1-8\"},\"PeriodicalIF\":33.7000,\"publicationDate\":\"2020-07-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8631757/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Mmwr Recommendations and Reports\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.15585/mmwr.rr6906a1\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Mmwr Recommendations and Reports","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.15585/mmwr.rr6906a1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

接触肝炎病毒是公认的医护人员 (HCP) 的职业风险。本报告制定了新的疾病预防控制中心指南,其中包括针对可能职业暴露于丙型肝炎病毒 (HCV) 的医护人员的检测算法和临床管理建议。应在暴露后尽快(最好在 48 小时内)对来源患者和 HCP 进行基线检测。源患者是指接受医疗保健服务的任何人,其血液或其他潜在传染性物质是 HCP 的暴露源。建议对源患者进行两种检测。第一种方案是通过核酸检测(NAT)对来源患者进行 HCV RNA 检测。该方案是首选方案,尤其是在已知或怀疑感染源患者近期有增加感染 HCV 风险的行为(如在过去 4 个月内使用过注射毒品)或风险无法可靠评估的情况下。第二种方案是检测来源患者的丙型肝炎病毒抗体(抗-HCV),如果呈阳性,则检测 HCV RNA。对于 HCP,应在接触后尽快(最好在 48 小时内)进行抗-HCV 基线检测,如果检测结果呈阳性,则进行 HCV RNA NAT 检测,并可与感染源患者检测同时进行。如果根据感染源患者的状态(如 HCV RNA 阳性或抗 HCV 阳性但 HCV RNA 不可用,或 HCV 感染状态未知)建议进行后续检测,则应在暴露后 3-6 周用 NAT 检测 HCP 的 HCV RNA。如果暴露后 3-6 周 HCV RNA 为阴性,建议在暴露后 4-6 个月进行抗 HCV 的最终检测。如果发现感染源患者或 HCP 的 HCV RNA 呈阳性,应转诊至护理机构。不建议职业性暴露于血液和其他体液的 HCP 进行暴露后丙型肝炎预防。本指南是根据专家意见制定的(CDC.美国公共卫生服务局关于职业暴露于 HBV、HCV 和 HIV 的管理指南更新版,以及暴露后预防的建议。MMWR Recommend Rep 2001;50[No.RR-11];补充图,https://stacks.cdc.gov/view/cdc/90288),并反映了专业组织建议治疗急性 HCV 感染的最新指南。医疗保健提供者可以利用该指南更新其暴露后检测程序以及对可能暴露于丙型肝炎病毒的 HCP 的临床管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Testing and Clinical Management of Health Care Personnel Potentially Exposed to Hepatitis C Virus - CDC Guidance, United States, 2020.

Testing and Clinical Management of Health Care Personnel Potentially Exposed to Hepatitis C Virus - CDC Guidance, United States, 2020.

Testing and Clinical Management of Health Care Personnel Potentially Exposed to Hepatitis C Virus - CDC Guidance, United States, 2020.

Exposure to hepatitis viruses is a recognized occupational risk for health care personnel (HCP). This report establishes new CDC guidance that includes recommendations for a testing algorithm and clinical management for HCP with potential occupational exposure to hepatitis C virus (HCV). Baseline testing of the source patient and HCP should be performed as soon as possible (preferably within 48 hours) after the exposure. A source patient refers to any person receiving health care services whose blood or other potentially infectious material is the source of the HCP's exposure. Two options are recommended for testing the source patient. The first option is to test the source patient with a nucleic acid test (NAT) for HCV RNA. This option is preferred, particularly if the source patient is known or suspected to have recent behaviors that increase risk for HCV acquisition (e.g., injection drug use within the previous 4 months) or if risk cannot be reliably assessed. The second option is to test the source patient for antibodies to hepatitis C virus (anti-HCV), then if positive, test for HCV RNA. For HCP, baseline testing for anti-HCV with reflex to a NAT for HCV RNA if positive should be conducted as soon as possible (preferably within 48 hours) after the exposure and may be simultaneous with source-patient testing. If follow-up testing is recommended based on the source patient's status (e.g., HCV RNA positive or anti-HCV positive with unavailable HCV RNA or if the HCV infection status is unknown), HCP should be tested with a NAT for HCV RNA at 3-6 weeks postexposure. If HCV RNA is negative at 3-6 weeks postexposure, a final test for anti-HCV at 4-6 months postexposure is recommended. A source patient or HCP found to be positive for HCV RNA should be referred to care. Postexposure prophylaxis of hepatitis C is not recommended for HCP who have occupational exposure to blood and other body fluids. This guidance was developed based on expert opinion (CDC. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR Recommend Rep 2001;50[No. RR-11]; Supplementary Figure, https://stacks.cdc.gov/view/cdc/90288) and reflects updated guidance from professional organizations that recommend treatment for acute HCV infection. Health care providers can use this guidance to update their procedures for postexposure testing and clinical management of HCP potentially exposed to hepatitis C virus.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Mmwr Recommendations and Reports
Mmwr Recommendations and Reports PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
36.00
自引率
0.00%
发文量
3
期刊介绍: The MMWR series of publications is published by the Office of Science, Centers for Disease Control and Prevention (CDC), U.S. The MMWR Recommendations and Reports contain in-depth articles that relay policy statements for prevention and treatment in all areas in the CDC’s scope of responsibility (e.g., recommendations from the Advisory Committee on Immunization Practices).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信