Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in health care workers (HCWs): guidelines for prevention of transmission of HBV and HCV from HCW to patients R.N. Gunson a,1 , D. Shouval b,2 , M. Roggendorf c , H. Zaaijer d , H. Nicholas e , H. Holzmann f , A. de Schryver g , D. Reynders h , J. Connell i , W.H. Gerlich j , R.T. Marinho k , D. Tsantoulas l , E. Rigopoulou l , M. Rosenheim m , D. Valla m , V. Puro n , J. Struwe o , R. Tedder p , C. Aitken q , M. Alter r , S.W. Schalm s , W.F. Carman a, * ,3 , European Consensus Group a West of Scotland Specialist Virology Centre, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 OZA, UK b Liver Unit, Hadassah-Hebrew University Hospital, Jerusalem, Israel c Institute for Virology, University of Essen, Essen, Germany d Medical Microbiology and Infection Control, VUMC University Hospital, Amsterdam, Netherlands e Department of Health, Skipton House, London, UK f Institute of Virology, University of Vienna, Vienna, Austria g IDEWE Occupational Health Service, Leuven, Belgium h Health Warning Unit, Ministry of Social Affairs, Public Health and the Environment, Brussels, France i National Virus Reference Laboratory, University College Dublin, Belfield, Dublin, Ireland j Institute for Medical Virology, University of Giessen, Giessen, Germany k Liver Unit, Department of Medicine, Hospital Santa Maria, Lisbon, Portugal l Liver Unit, Athens Medical Centre, Athens, Greece m Service of Public Health, Ho ˆpital Pitie ´-Salpe ˆtrie `re, Paris, France n Department of Epidemiology, National Institute for Infectious Diseases, Rome, Italy o Division of Infectious Diseases, University Hospital at Karolinska Institutet, Stockholm, Sweden p Department of Virology, Royal Free and University College Medical School, London, UK q Department Virology, Barts and the London, UK r Division of Viral Hepatitis, National Centre for Infectious Diseases, CDC, Atlanta, Georgia s Gastroenterology and Hepatology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands Received 20 March 2003; accepted 25 March 2003 * Corresponding author. Tel.:  /44-141-211-0080; fax:  /44-141-211-0082. E-mail address: w.carman@vir.gla.ac.uk (W.F. Carman). 1 The consensus meeting and final report was organised by R.N. Gunson, D. Shouval and W.F. Carman. R.N. Gunson and D. Shouval are primary co-authors of this report. Abbreviations: Anti HBc, antibody to hepatitis B core protein is a marker of current (in the presence of HBsAg) or past infection with HBV; Anti HBe, antibody to hepatitis e antigen can be a marker for low infectivity (in the presence of HBsAg, especially in wild type infection); Anti HCV, antibody to HCV is a marker of current (in the presence of HCV RNA) or past infection with HCV; CDC, centres for disease control; EPP, exposure prone procedures is the term for invasive procedures where there is potential for contact between the skin of the HCW and sharp surgical instruments, needles or sharp tissues in body cavities or poorly visualised/confined body sites; HBeAg, hepatitis B e antigen is a marker of level of infectivity; HBsAg, hepatitis B surface antigen detectable in serum in the majority of HBV infected patients; HBV, hepatitis B virus; HBV DNA, hepatitis B nucleic acids. Can be used to monitor infectivity Journal of Clinical Virology 27 (2003) 213  /230 www.elsevier.com/locate/jcv 1386-6532/03/$ - see front matter # 2003 Elsevier Science B.V. All rights reserved. doi:10.1016/S1386-6532(03)00087-8