Surgeons who test positive for hepatitis C should not be transferred to low risk duties.
Current UK guidelines allow surgeons who are antibody-positive for hepatitis C virus (HCV) to continue performing exposure-prone procedures (EPPs) unless they have been shown to transmit HCV to a patient. Given the low rate of recognised transmission from surgeon to patient, this recommendation is probably reasonable and is consistent with the management of eAg negative carriers of hepatitis B who are also allowed to continue operating. It seems likely that, in the future, pressure will increase to remove surgeons who are HCV-positive (or positive for HBsAg without HBeAg or HIV-positive) from the list of those able to perform EPPs. If implemented, this would require surgeons to be tested at regular intervals for HCV status. There are no data to demonstrate that such an approach would benefit patients overall and the ethical costs would be high because many surgeons will have acquired HCV occupationally. The financial costs would also be high and, in my opinion, would be better deployed by ensuring that existing simple preventative measures are routinely applied to prevent patient-surgeon-patient transmission of all blood-borne viruses.
Cockcroft
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Department of Occupational Health, Royal Free Hampstead NHS Trust, London, UK.
D006526:Hepatitis C / Q000175:diagnosis / Q000635:transmission*; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*