[The Significance of Hepatitis B Infection to Nurses, Paramedics, and Laboratory Workers]


Carreño V, Porres JC, Hernández Guío C, Marina Fiol C, Alvarez C, Hernando L.

In order to study the risk of exposure to hepatitis B virus of hospital personnel from different departments, incidences of HBsAg, anti-HBs, anti-HBc, HBeAg, and anti-HBe were determined by means of radioimmunoassay. The following groups were studied: (A) 190 healthy control subjects (nonhospitalized, non-blood donors); (B) laboratory technicians; (C) 565 members of the gastroenterology department; (D) 118 workers from the hemodialysis unit (HU).

The following prevalences for one or another positive marker of hepatitis B were found: (A) control subjects, 14.7 percent; (B) laboratory technicians, 22.5 percent; (C) gastroenterology staff members, 26.7 percent; (D) HU staff members, 38.2 percent. The difference in prevalence between the control group and the collective staff (32.2 percent) was statistically significant (p<0.0005).

Since the highest prevalence was found in the HU, three other HUs of different hospitals were studied (159 persons). The prevalence in each HU was related to the percentage of patients testing positive for HBsAg and separated according to time of dialysis and individual HU. The most frequent patterns of tracers found were simultaneous positive readings for anti-HBs and anti-HBc (37.2 percent) and for anti-HBs, anti-HBc, and anti-HBe (27.4 percent). Considering the frequency of a previous outbreak of acute hepatitis type B in relation to these patterns, the percentages in each group were anti-HBs and anti-HBc, 29.7 percent; and anti-HBs, anti-HBc, and anti-HBe, 53.8 percent, respectively.

Clearly, hospital personnel experience a greater risk of exposure to hepatitis B virus than the general population. Among the hospital staff studied, the highest exposure risk is of HU personnel. The prevalence of tracers in an HU is conditioned by the percentage of patients positive for HBsAg dialyzed per year. The anti-HBe associated with anti-HBs and anti-HBc is frequently detected among persons with a previous history of clinical hepatitis.