Hepatitis B in healthcare workers: Transmission events and guidance for management

作     者：Jessica D Lewis Kyle B Enfield Costi D Sifri 

作者机构：Division of Infectious Diseases and International Health Department of Medicine University of Virginia Health System Division of Pulmonary and Critical Care Medicine Department of Medicine University of Virginia Health System Office of Hospital Epidemiology/Infection Prevention and Control University of Virginia Health System 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2015年第7卷第3期

页      面：488-497页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：Supported by National Institutes of Health Infectious Diseases Training Grant No.5T32AI007046-37 

主　　题：Hepatitis B Healthcare worker Blood-bornepathogens Transmission Invasive procedures 

摘      要：Hepatitis B virus(HBV) is the most efficiently transmissible of the bloodborne viruses that are important in healthcare settings. Healthcare workers(HCWs)are at risk for exposure to HBV from infected patients and, if infected, are similarly at risk of transmitting HBV to patients. Published cases of HBV transmission from HCW to patient are relatively rare, having decreased in frequency following the introduction of standard(universal) precautions, adoption of enhanced percutaneous injury precautions such as double-gloving in surgery, and routine HBV vaccination of HCWs. Here we review published cases of HCW-to-patient transmission of HBV, details of which have helped to guide the creation of formal guidelines for the management of HBV-infected HCWs. We also compare the published guidelines for the management of HBV-infected HCWs from various governing bodies, focusing on their differences with regard to vaccination requirements, viral load limits, frequency of monitoring, and restrictions on practice. Importantly, while there are differences among the recommendations from governing bodies, no guidelines uniformly restrict HBV-infected HCWs from performing invasive or exposure-prone procedures.