The current national guidance which restricts healthcare workers with HIV from performing invasive clinical procedures, known as exposure prone procedures has been jointly reviewed by the Expert Advisory Group on AIDS, the UK Advisory Panel for Healthcare Workers Infected with Blood-borne Viruses and the Advisory Group on Hepatitis.
With just four reported incidences worldwide of transmission of HIV from a healthcare worker to a patient and no cases in the UK, the working group’s assessment of available evidence suggests the risk of transmission is extremely low for the most invasive procedures and is negligible for less invasive procedures.
The review recommends that HIV-infected healthcare workers be permitted to carry out exposure prone procedures provided the worker is on combination antiretroviral drug therapy (cART) and has a suppressed viral load to very low or undetectable levels (below 200 copies per ml).
The review recommends other conditions which the healthcare worker must adhere to including a demonstrated sustained response to cART, the requirement to be under the joint supervision of a consultant in occupational medicine and a treating physician and quarterly testing of viral load.
Where a healthcare worker fails to comply with monitoring arrangements or where viral load rises significantly, the healthcare worker should be restricted from performing exposure prone procedures.
More on the recommendations from the review and details of the consultation can be found from the Department of Health’s consultation webpage. The consultation runs from 1 December 2011 to 9 March 2012.