This guideline provides the updated recommendations of SHEA regarding the management of healthcare providers who are infected with HBV, HCV, and/or HIV. SHEA continues to recommend that, although some aspects of the approach to and administrative management of each of these infectious syndromes in healthcare providers are similar, separate management strategies for healthcare workers who are infected with these unrelated viruses remain appropriate. SHEA emphasizes the use of appropriate infection control procedures to minimize exposure of patients or providers to blood, emphasizes that transfers of blood from patients to providers and from providers to patients should be avoided, and recommends that infected healthcare providers should not be totally prohibited from participating in patient‐care activities solely on the basis of a bloodborne pathogen infection.

Review Statement: 

This guideline was reviewed in July 2017 by the SHEA Guidelines Committee. The committee acknowledges portions of the guideline need to be revised based on new evidence, improved antiviral treatment regimens, and changes to reporting practices; however, the committee voted to keep it available on the SHEA website as numerous recommendations and most of the background information remains current and may inform regulations and individual institution's decisions. Questions and clarifications regarding the posted guideline should be sent to the SHEA Guidelines Committee.

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SHEA Response to Institutions’ Implementation of 2010 Guideline for Healthcare Workers Infected with Bloodborne Pathogens
October 2014

Since publication of the SHEA position paper on Clostridium difficile infection in 1995, significant changes have occurred in the epidemiology and treatment of this infection. C. difficile remains the most important cause of healthcare‐associated diarrhea and is increasingly important as a community pathogen. A more virulent strain of C. difficile has been identified and has been responsible for more‐severe cases of disease worldwide. Data reporting the decreased effectiveness of metronidazole in the treatment of severe disease have been published. Despite the increasing quantity of data available, areas of controversy still exist. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management.