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 hepatiti s C virus (HCV) to continue performing exposure-prone procedures (EPPs) unl ess they have been shown to transmit HCV to a patient. Given the low rate o f recognised transmission from surgeon to patient, this recommendation is p robably reasonable and is consistent with the management of eAg negative ca rriers of hepatitis B who are also allowed to continue operating. It seems likely that, in the future, pressure will increase to remove surgeons who a re 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 dat a to demonstrate that such an approach would benefit patients overall and t he 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 mea sures are routinely applied to prevent patient-surgeon-patient transmission of all blood-borne viruses. Copyright (C) 2000 John Wiley & Sons, Ltd.