Hepatitis B: Prevention, Protection and Occupational Risk

Andrea Trevisan; Annamaria Nicolli; Federica Chiara

Disclosures

Future Virology. 2015;10(1):53-61. 

In This Article

Abstract and Introduction

Abstract

Since 1992, the inclusion of HBV vaccination has been recommended by the WHO for all immunization programs implemented by nations. In Europe, the introduction of HBV vaccination has markedly reduced the incidence of acute HBV, and before the introduction of HBV vaccine, healthcare workers (HCW) were at considerable risk of infection. The present review discusses the main problems regarding three fundamental issues in hospital settings: prevention of HBV in HCW, protection induced by vaccination (problems regarding nonresponders) and risk for HCW exposed to blood-borne pathogens (occupational risk). The screening of HBV markers plays a decisive role in evaluating the degree of immune coverage in subjects exposed to biological risk and permits an increase in immune coverage through vaccine implementation.

Introduction

HBV infection is a significant biological risk for healthcare workers (HCW), as HCW are exposed to human fluids and consequently to blood-borne pathogens. Prior to the introduction of the vaccination against HBV, the risk of infection was three- to five-times higher in HCW than in the general population, with vaccination and the application of standard precautions contributing to reduce this risk.[1]

Since 1992, the inclusion of hepatitis B vaccination has been recommended by the WHO in all immunization programs implemented by nations. Indeed, the introduction of HBV vaccination in Europe has markedly reduced the incidence of acute infection.

The introduction of mandatory HBV vaccination in Italy (law 165/1991) has contributed to reducing the incidence of the disease, even in the age group with the highest incidence (15–24 years old), which is largely related to the abuse of parenteral drugs and/or exposure to other risk factors such as unsafe sexual contact.[2]

The present review intends to highlight the problem of the occupational risk for HCW according to three main items: the prevention of HBV infection (efficacy of vaccination); the protection against HBV infection, discussing both problems related to waning antibodies and those related to nonresponders; and the reduction of occupational risk.

Comments

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