The CDC has upheld its 1991 recommendation that hepatitis B virus (HBV) infection alone should not disqualify health-care workers from the practice or study of surgery, dentistry, medicine or allied health fields.

“For most chronically HBV-infected providers and students who conform to current standards for infection control, HBV infection status alone does not require any curtailing of their practices or supervised learning experiences,” the updated recommendations stated (MMWR. 2012;61[RR03]:1-12).

The document does make the following changes to the 1991 version: (1) no prenotification of patients as to a health-care provider’s or student’s HBV status; (2) use of HBV DNA serum levels rather than hepatitis B e-antigen status to monitor infectivity; and (3) for those health-care professionals requiring oversight, specific suggestions for composition of expert review panels and threshold value of serum HBV DNA considered safe for practice (<1,000 IU/mL).

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In other hepatitis developments, silymarin — an extract of milk thistle used by many people to combat liver ailments — has been deemed an ineffective treatment for chronic hepatitis C virus (HCV) infection in a study of 154 persons who had previously been treated unsuccessfully with conventional interferon-based therapy.

After 24 weeks of therapy with silymarin 420 mg or 720 mg t.i.d., or placebo, only two participants (3.8%) in each treatment group achieved normal serum alanine aminotransferase (ALT) levels or a reduction of at least 50% from baseline ALT levels. No significant differences were seen in the decline of serum ALT activity, HCV RNA levels, or quality-of-life measures across the three groups (JAMA. 2012;308:274-282).