Hepatitis C virus positive healthcare personnel is prohibited of invasive medical interventions by law in Hungary: is it necessary?

Background: 18/1998. (VI.3.) Health Minister's decree prohibits Hepatitis-C-Virus-(HCV) – PCR positive medical professionals from performing any invasive medical intervention that is widely debated within the medical society but it is strongly supported by law professionals.

Aim: We would like to draw attention to the decree, to discuss it in detail and to list relevant pros and contras.

Results: The prevalence of anti-HCV IgG -positivity is 0.7–1% in the whole population and it is 2.4% in the medical staff in Hungary. Based on the recommendation of CDC/1998 it is not necessary to limit professional activities in such cases as while the risk of spreading HCV- infection with blood from a HCV-positive person through accidental „needle-stick-like injury“ is 1.8%, it is only 0,00018% from a HCV- positive medical person to a patient and it is 0,014% from a HCV – positive surgeon to a patient. There is 50% chance for a patient to become infected with HCV during 5000 operations in ten years. It is the same chance as one gets HCV-infection from a screened, HCV-IgG-negative blood transfusion.

However, according to the decree any concerned HCV-positive healthcare staff is forbidden to carry on any invasive techniques. Medical careers can be resituated after two negative PCR results carried out by a validated lab.

Conclusions: Excluding HCV- positive medical staff from invasive operations is not necessary as it does not reduce infection risk and in addition to that such discrimination is harmful for the patient as it deprives him/her of skilled experts. Alone surgeons, gastroenterologists, dentists whose medical carrier is broken if they get infected. This is why such prohibition does not exist in the United States and in other countries of the European Union, according to our knowledge.