HBV DNA levels and transmission of hepatitis B by health care workers

Corden, Sally; Ballard, Anna; Ijaz, Samreen; Barbara, J. A. J.; Gilbert, Nicola; Gilson, Richard; Boxall, Elizabeth; Tedder, Richard S.

doi:10.1016/s1386-6532(02)00127-0

Cited by 48 publications

(32 citation statements)

References 14 publications

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“…The correlation between the presence of HBeAg in serum and infectivity was recognized within a few years of the discovery of the virus (240). HBV DNA testing gradually replaced HBeAg as a sensitive and accurate indicator of infectivity (58). The presence of maternal serum HBeAg has been identified as a major risk factor for transplacental transmission of HBV (286).…”

Section: Hbv Epidemiologymentioning

confidence: 99%

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

2012

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SUMMARY Chronic hepatitis B virus (HBV) infection is a complex clinical entity frequently associated with cirrhosis and hepatocellular carcinoma (HCC). The persistence of HBV genomes in the absence of detectable surface antigenemia is termed occult HBV infection. Mutations in the surface gene rendering HBsAg undetectable by commercial assays and inhibition of HBV by suppression of viral replication and viral proteins represent two fundamentally different mechanisms that lead to occult HBV infections. The molecular mechanisms underlying occult HBV infections, including recently identified mechanisms associated with the suppression of HBV replication and inhibition of HBV proteins, are reviewed in detail. The availability of highly sensitive molecular methods has led to increased detection of occult HBV infections in various clinical settings. The clinical relevance of occult HBV infection and the utility of appropriate diagnostic methods to detect occult HBV infection are discussed. The need for specific guidelines on the diagnosis and management of occult HBV infection is being increasingly recognized; the aspects of mechanistic studies that warrant further investigation are discussed in the final section.

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Section: Hbv Epidemiologymentioning

confidence: 99%

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

2012

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“…[25] The risk of transmission between healthcare workers and patients has been well documented. [24,26] There is therefore a risk of clipper contamination from minor bleeding on the scalp. The infectious dose of hepatitis B has been estimated at 10 -100 viruses.…”

Section: Discussionmentioning

confidence: 99%

Blood and virus detection on barber clippers

et al. 2018

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Background.Bleeding from the popular clean-shave 'chiskop' haircut was recently reported as prevalent in South Africa (SA), a country with 6.9 million HIV-infected people. Objectives. To investigate the prevalence of barber hair clipper contamination with blood and HIV and hepatitis B viruses. Methods. Fifty barbers from three townships in Cape Town, SA, were invited to participate. One clipper from each barber was collected immediately after it had been used for a clean-shave haircut. Each clipper was rinsed with phosphate-buffered saline and then submerged in viral medium. The polymerase chain reaction (PCR) was used to identify the blood-specific RNA marker haemoglobin beta (HBB), hepatitis B virus (HBV) and HIV. Conclusion. This study confirms that there is significant contamination of barber hair clippers with blood and blood-borne viruses. Hepatitis B was detected with enough DNA copies to pose a risk of transmitting infection. Although HIV was not detected in this small study, the risk of transmission should be quantified. Further studies to investigate barber clipper sterilisation practices and whether the clean-shave hairstyle is an independent risk factor for HIV, HBV and hepatitis C virus infections are warranted. Public education on individual clipper ownership (as is the case with a toothbrush) should be advocated for clean-shave and blade-fade haircuts.

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“…In fact, none of the 4 chimpanzees inoculated with 1:10 dilutions of the anti-HBe-positive sample was infected and only 1 was infected with the undiluted sample. Unfortunately, HBV DNA assays were not done in the 1970s, but a later study from Corden et al [17] showed that ‘HBV DNA could be detected and quantified in 64.5% (136 of 211) of carriers whose serum did not contain HBeAg with a median level of 3.6 log 10 copies/ml (range of 5.7 log 10 copies)'. Thus, it is probable that the inoculum used by Shikata et al [16] contained around 1,000 GE/ml, but it was not infectious at 1:10 dilution.…”

Section: Transmissibility Of Hbvmentioning

confidence: 99%

“…The transmission rates are 10 times lower during high-risk operations and all 4 physicians for whom viremia was reported had 10 6 GE/ml or more. As an exception, Corden et al [17] reported that one surgeon who had transmitted HBV had only 64,000 GE/ml. However, the sample for viral load quantification was taken at least 3 months after the transmission event and, furthermore, the calibration of the test may have been too low by a factor of 5 [19].…”

Section: Transmission Of Hbv From Healthcare Providers To Patientsmentioning

confidence: 99%

Reduction of Infectivity in Chronic Hepatitis B Virus Carriers among Healthcare Providers and Pregnant Women by Antiviral Therapy

Gerlich

2014

Intervirology

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The main purpose of therapy for infectious diseases is restoration or protection of the patient's health, but suppression or elimination of infectious agents is also important. In two well-defined situations, reduction of potential infectivity may be the main reason for therapy in hepatitis B virus (HBV) carriers who do not suffer from significant disease: (1) healthcare providers who perform exposure-prone procedures to prevent transmission of HBV to individuals, and (2) pregnant women in the third trimester to prevent transmission to the fetus. This article describes the necessity to recognize highly viremic HBV-infected individuals in these situations, the methods to estimate the risk of transmission, and the therapeutic possibilities to prevent transmission. With today's methods of monitoring HBV DNA, it is possible to reliably estimate the risk of transmission. The drugs entecavir or tenofovir are able to suppress infectivity of HBV carriers to levels acceptable for healthcare providers performing exposure-prone procedures. According to the CDC, ‘chronic HBV infection in itself should not preclude the practice or study of medicine, surgery, dentistry, or allied health professions.' Treatment of pregnant women with very high levels of HBV DNA prevents the transmission to the fetus and further if the newborn receives immediate active/passive immunization against HBV.

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HBV DNA levels and transmission of hepatitis B by health care workers

Cited by 48 publications

References 14 publications

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

Blood and virus detection on barber clippers

Reduction of Infectivity in Chronic Hepatitis B Virus Carriers among Healthcare Providers and Pregnant Women by Antiviral Therapy

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