Hepatitis C Post-Exposure Prophylaxis for Healthcare Personnel: Policy Analysis Among Philadelphia's Large Teaching Institutions

The National Institute for Occupational Safety and Health reports that the exact number of bloodborne pathogen (BBP) exposures in the United States is unknown.1,2 The incidence of hepatitis C (HCV) transmission after BBP exposure from an HCV patient is estimated to be 1.8%.3 Because no HCV vaccine exists nor does the Centers for Disease Control and Prevention recommend post-exposure prophylaxis (PEP) for HCV, long-term health threats from exposure to HCV remain for healthcare personnel (HCP). The policies of the other 2 institutions used particular wording to address PEP: “There is no immediate treatment for exposure to hepatitis C” and “Prophylaxis will be provided according to OM [Occupational Medicine] protocols and the most recent recommendations from the US Public Health Service and [the institution’s] Infectious Disease experts.” [...]we believe that in an era of needleless systems, the rate of HCV exposure through needlestick may continue to decrease, but the seroconversion frequency will only decrease when there is effective PEP.