Hepatitis C virus (HCV) infection is a significant contemporary health problem in the United States and elsewhere. Because it is primarily transmitted via blood, hepatitis C infection presents risks for both nosocomial transmission to patients and occupational spread to health care workers. Recent insights into the pathogenesis, immunopathogenesis, natural history, and treatment of infection caused by this unique flavivirus provide a rationale for the use of new strategies for managing occupational hepatitis C infections when they occur. This article reviews this developing information. Recently published data demonstrate success rates in the treatment of "acute hepatitis C syndrome" that approach 100\%, and although these studies are not directly applicable to all occupational infections, they may provide important clues to optimal management strategies. In addition, the article delineates approaches to the prevention of occupational exposures and also addresses the difficult issue of managing HCV-infected health care providers. The article summarizes currently available data about the nosocomial epidemiology of HCV infection and the magnitude of risk and discusses several alternatives for managing exposure and infection. No evidence supports the use of immediate postexposure prophylaxis with immunoglobulin, immunomodulators, or antiviral agents. Based on the very limited data available, the watchful waiting and preemptive therapy strategies described in detail in this article represent reasonable interim approaches to the complex problem of managing occupational HCV infections, at least until more definitive data are obtained.

中文翻译：

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管理医疗保健环境中丙型肝炎传播的职业风险。

丙型肝炎病毒（HCV）感染是美国和其他地方的一个重要的当代健康问题。由于丙型肝炎主要通过血液传播，因此丙型肝炎感染既存在医院内传播给患者的风险，也存在职业传播给医护人员的风险。最近对这种独特黄病毒引起的感染的发病机制、免疫发病机制、自然史和治疗的见解为使用新策略来管理职业性丙型肝炎感染提供了理论基础。本文回顾了这一发展信息。最近发表的数据表明，“急性丙型肝炎综合征”的治疗成功率接近100%，尽管这些研究并不直接适用于所有职业感染，但它们可能为最佳管理策略提供重要线索。此外，本文还阐述了预防职业暴露的方法，并解决了管理感染 HCV 的医疗保健提供者的难题。本文总结了有关 HCV 感染的医院流行病学和风险程度的现有数据，并讨论了管理暴露和感染的几种替代方案。没有证据支持暴露后立即使用免疫球蛋白、免疫调节剂或抗病毒药物进行预防。基于非常有限的可用数据，本文详细描述的观察等待和先发制人的治疗策略代表了解决职业性 HCV 感染这一复杂问题的合理临时方法，至少在获得更明确的数据之前是这样。