ADC Practice Question — Hand Hygiene

Dr Sharma's HBV DNA viral load of 150 IU/mL, can she…

Infection control in the ADC exam tests decision-making around exposure incidents, instrument classification, and decontamination protocols. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

Dr Priya Sharma is a dental practitioner who has recently been diagnosed with chronic hepatitis B infection. Her HBV DNA test shows a viral load of 150 IU/mL. She regularly performs surgical extractions and implant placements. A colleague advises her she should stop performing all dental procedures. Meanwhile, a new patient Mr Thompson discloses he is HIV-positive and requests a routine dental check-up. Given Dr Sharma's HBV DNA viral load of 150 IU/mL, can she continue performing exposure-prone procedures (EPPs)?

A. No — all HBV-positive practitioners must cease performing EPPs
B. Yes — HCWs who are HBV DNA positive can perform EPPs if viral load is below 200 IU/mL
C. Yes — but only non-surgical procedures
D. Only after 6 months of antiviral therapy regardless of viral load

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: B

HCWs who are HBV DNA positive are permitted to perform EPPs if they have a viral load below 200 international units (IU)/mL and meet the other criteria set out in the CDNA Guidelines. Dr Sharma's viral load of 150 IU/mL is below the 200 IU/mL threshold. (ICG p.14)

Source: ICG Section A: Practitioners with Infectious Disease

Remy's study tip — The differentiator is usually the Spaulding classification level or the step order in a protocol.

Exam preparation FAQ

How do I approach an unfamiliar Hand Hygiene vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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