Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. (Morbidity and Mortality Weekly Report Supplement, Aug. 15, 1991) (Reviews and Information From Periodicals and Journals Worldwide)

SOURCE: Morbidity and Mortality Weekly Report Supplement, August 15, 1991.

"This document has been developed by the Centers for Disease Control (CDC) to update

recommendations for prevention of transmission of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) in the healthcare setting. Current data suggest that the risk for such transmission from a healthcare worker (HCW) to a patient during an invasive procedure is small; a precise assessment of the risk is not yet available. This document contains recommendations to provide guidance for prevention of HIV and HBV transmission during those invasive procedures that are considered exposure prone. Introduction

"Recommendations have been made by the CDC for the prevention of transmission of the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV) in healthcare settings. These recommendations emphasize adherence to universal precautions that require that blood and other specified body fluids of all patients be handled as if they contain bloodborne pathogens.

"Previous guidelines contained precautions to be used during invasive procedures (defined in Appendix) and recommendations for the management of HIV- and HBV -infected healthcare workers (HCWs). These guidelines did not include specific recommendations on testing HCWs for HIV or HBV infection, and they did not provide guidance on which invasive procedures may represent increased risk to the patient.

"The recommendations outlined in this document are based on the following considerations:

* Infected HCWs who adhere to universal precautions and who do not perform invasive procedures pose no risk for transmitting HIV or HBV to patients.

* Infected HCWs who adhere to universal precautions and who perform certain exposure-prone procedures pose a small risk for transmitting HBV to patients.

* HIV is transmitted much less readily than HBV.

"In the interim, until further data are available, additional precautions are prudent to prevent HIV and HBV transmission during procedures that have been linked to HCW-to-patient HBV transmission or that are considered exposure prone.

Background

Infection-Control Practices

"Previous recommendations have specified that infection-control programs should incorporate principles of universal precautions (i.e., appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments) and should maintain these precautions rigorously in all healthcare settings. Proper application of these principles will assist in minimizing the risk of transmission of HIV or HBV from patient to HCW, HCW to patient, or patient to patient.

"As part of standard infection-control …