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Viral Hepatitis in Health Care Personnel at The Johns Hopkins HospitalThe Seroprevalence of and Risk Factors for Hepatitis B Virus and Hepatitis C Virus Infection
David L. Thomas, MD, MPH;
Stephanie H. Factor, MPH;
Gabor D. Kelen, MD;
Antonio S. Washington, MD;
Eric Taylor, Jr, MD;
Thomas C. Quinn, MD, MSc
Arch Intern Med. 1993;153(14):1705-1712.
Abstract
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Background
Health care personnel are at increased risk of occupational acquisition of hepatitis B virus (HBV) infection. While effective vaccination for HBV is widely available, the prevalence of HBV and vaccine acceptance in hospital personnel have not been recently assessed. In addition, hepatitis C virus (HCV) is a newly recognized cause of parenterally acquired hepatitis, and the risk of HCV transmission to health care personnel remains unclear.
Methods
From April to December 1991, health care personnel at The Johns Hopkins Hospital, Baltimore, Md, were offered anonymous testing for HBV and HCV and were asked to complete a confidential questionnaire. Serum samples were tested for HBV surface antigen and antibodies to HBV core antigen, HBV surface antigen, and HCV. Seroprevalence rates were compared with those detected in local blood donors during the same year.
Results
Antibodies to HBV core antigen were found in 59 (6.2%) of 943 health care workers compared with 1879 (1.8%) of 104 239 local blood donors (P<.001). In contrast, antibodies to HCV were found in seven (0.7%) of 943 health care workers and 0.4% of local blood donors (P=.10). Infection with HBV was associated with age ( 33 years) (P<.001), black race (P<.001), type of health care worker (nurse) (P=.02), 10 or more years of clinical employment (P=.003), and lack of HBV vaccination (P<.001). After logistic regression, only absence of HBV vaccination was independently associated with HBV infection (P<.001).
Conclusion
These data suggest that the prevalence of HCV infection in health care personnel at The Johns Hopkins Hospital is similar to that observed in local blood donors, and that HBV may be more efficiently transmitted than HCV in the health care setting. Efforts to vaccinate health care personnel against HBV should be vigorously pursued since 23% remain unvaccinated after 9 years of HBV vaccine availability.
(Arch Intern Med. 1993;153:1705-1712)
Author Affiliations
From the Divisions of Infectious Diseases (Drs Thomas, Washington, Taylor, and Quinn and Ms Factor) and Emergency Medicine (Dr Kelen), The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Md, and the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md (Dr Quinn). Dr Washington is now with the Department of Internal Medicine, Massachusetts General Hospital, Boston.
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