In drug misusers, this may be mistaken for signs of withdrawal. Treatment may be withheld from heavy drinkers. With regard to IDUs, the British Liver Foundation comments that treatment for HCV will normally only be considered for those on a stable methadone maintenance programme. As interferon is administered by injection, this may be an issue for ex-injectors. Protecting health workers The Department of Health has issued guidance for HIV and hepatitis vaccines.
Advice is based on the principle that all blood and body fluids are potentially infectious.
Safe handling and disposal of sharps is an issue for community pharmacists. Recommendations for this have been published by the Royal Pharmaceutical Society and most needle exchange schemes also provide guidance on safe handling and waste disposal. Transmission is associated with contaminated blood products. HDV may seriously exacerbate any HBV infection and co-infection may lead to more rapid liver failure. However, there is no vaccination and it is thought that HAV immunoglobulin does not protect against the disease.