Hepatitis B and C and Biosafety in HOF: Standard Precautions

Hepatitis B and hepatitis C are viral infections that can be transmitted by contaminated blood and fluids. In HOF, contact with needles, cannulas, syringes and small skin lesions creates conditions for exposure, for both the patient and the professional. The good news is that the path to safety is known and simple: treat all patients with the same precautions, vaccinate those who work with sharps and have a plan for injuries.

This page gathers the reasoning, without replacing your practice's protocol or health regulations. For the general context, see biosafety in HOF, sharps disposal and PGRSS (Brazil's health service waste management plan) and sharps injury.

Why do hepatitis B and C call for attention?

Both are liver infections, and both can stay silent for a long time. A person can carry and transmit the virus without knowing. Some useful characteristics for the professional:

Clinical and therapeutic details belong to the treating physician. For the HOF professional, what matters is prevention: no one should depend on knowing the diagnosis to decide whether to protect themselves.

What are standard precautions in practice?

Standard precautions are the set of measures applied to all patients, regardless of diagnosis. In HOF, this involves:

• Hand hygiene before and after each patient and each procedure.
• Disposable gloves, changed between patients and when contaminated.
• Eye and mucosal protection when there is a risk of splashes.
• Field and surfaces organized, with disinfection between appointments.
• Disposable, single-patient sharps, discarded immediately in a suitable container, without recapping needles.
• Reusable equipment processed according to the rules, see sterilization of reusable instruments.
• Skin antisepsis before injection, see chlorhexidine in facial antisepsis.
• Multidose vials handled with strict aseptic technique; see managing botulinum toxin vials.
• Organized work surface to reduce accidental contact, see organizing the procedure tray.

How to protect the professional?

The HOF professional handles needles and cannulas several times a day. Protection has three pillars:

1. Vaccination. The hepatitis B vaccine is recommended for health professionals, with a check of the schedule and, when indicated, of the vaccine response. Check with the occupational health service or your physician.
2. Technique. Avoid handling the needle with the other hand, do not recap, discard promptly, keep the container within reach and do not exceed the fill line.
3. Injury plan. Every team member must know what to do, whom to notify and where to seek care. The workflow must be written and rehearsed.

What about a patient who has or has had hepatitis?

A patient with hepatitis deserves the same respect and care as any other. The difference lies in some clinical decisions, which depend on the state of the liver, the treatment and the treating physician.

• Medical history. Ask about liver disease, medications and ongoing treatments, as part of the medical history in HOF. There is no need to insist when the patient does not want to give details.
• Bleeding and coagulation. Advanced liver disease can alter coagulation, which increases the risk of bruising. When in doubt, talk to the treating physician. See coagulation disorders in HOF.
• Medications. Some treatments affect blood, skin and healing. Review the medication list.
• Clearance. In active or decompensated disease, consider asking for the physician's clearance before elective procedures.
• No discrimination. Do not delay, refuse or treat worse because of the diagnosis alone. Refusal based on stigma is ethically indefensible.

Confidentiality and LGPD

Information about hepatitis is health data, classified as sensitive personal data under the LGPD (Brazil's General Data Protection Law). This requires a clear purpose, restricted access and professional confidentiality. In practical terms:

• record in the patient record only what is needed for care;
• do not mention the diagnosis at the front desk, in messaging groups or in front of companions;
• do not use the information to flag the record in a discriminatory way;
• brief the team on confidentiality.

See patient record and documentation in HOF and LGPD.

Requesting serology: when and how?

There is no reason to request routine serology as a condition for aesthetic care in patients without symptoms, because standard precautions should already protect everyone. Ordering tests may be justified in specific clinical contexts, such as suspected liver disease, medications that require monitoring or guidance from the treating physician. What must not happen is using the result to select who will be treated with more or less care.

Using serology after a sharps injury is a different matter: the occupational health service's workflow guides testing of the professional and, when possible and authorized, of the source patient.

What to record?

In the patient record, document the relevant health information the patient provided, the management and the advice given. For an injury, record date, time, type of exposure, immediate measures, place of care and follow-up. Records feed service improvement and protect everyone.

And in Harmy?

Summary

For hepatitis B and C, the best strategy in HOF is universal prevention: the same precautions for everyone, hepatitis B vaccination for the professional, safe disposal, a known injury plan and confidentiality of information. A patient with hepatitis should be treated with respect and with the clinical adaptations the treating physician recommends.