Hepatitis B and C among healthcare workers and patient groups at increased risk of iatrogenic transmission in the European Union/European Economic Area

Abstract

Summary In the European Union/European Economic Area (EU/EEA) approximately 9 million people are chronically infected with hepatitis B virus (HBV) or hepatitis C virus (HCV), and many are undiagnosed. Targeted active case finding initiatives are needed. Iatrogenic transmission of HBV/HCV is relevant in Europe but people at risk of infection are often overlooked. This study aimed to identify groups at increased risk of HBV/HCV infection due to iatrogenic transmission, including healthcare workers, and to estimate incidence and prevalence. PubMed and Embase were systematically searched in February 2017 using strings combining terms for HBV/HCV, occurrence and population subgroups. All retrieved publications were screened and included articles were quality assessed. A predefined set of variables were extracted, and detailed summary tables were developed per population group of interest, virus and outcome. Thirty-eight articles were included, two reported on HBV, 22 on HCV and 16 on both, contributing 70 estimates of prevalence or incidence among: haemodialysis recipients, diabetes patients, recipients of substances of human origin, recipients of medical/dental procedures and healthcare workers. Estimates varied widely from 0.4% to 11.7% for HBV and from 0.7% to over 90% for HCV with most being higher than in the general population. Despite the limited number of studies retrieved, mostly old and focused on populations with multiple risk factors, our findings highlight the importance of considering population groups at higher risk for HBV/HCV iatrogenic transmission as target groups for active case finding in the EU/EEA. Test offers should be guided by individual risk assessment alongside local epidemiological data and local context.

Frequency of hepatitis B and C in health care providers at three referral hospitals in Libya

“…In contrast, the frequency of Anti-hepatitis C antibodies (2.2%) was slightly higher to the frequency observed among the general population of Libya (1.3%) [ 6 ]. The frequency of HBsAg was high comparing to the previous studies reported from neighboring countries (i.e., Tunisia 2% and Egypt 1.4%) and developed countries (0.6% to 2.2%) [ 16 - 18 ].…”

Occupational exposures to blood and body fluids among healthcare workers in Ethiopia: a systematic review and meta-analysis

“…Occupational exposure to blood and body fluids (BBFs) is a major risk factor for the transmission of blood-borne infections to healthcare workers (HCWs). These exposures can heighten the risk of infection to human immunodeficiency virus (HIV), hepatitis B, and hepatitis C. In many cases, exposures occur through mucocutaneous injury (splash of blood or other body fluids into the eyes, nose, or mouth) or non-intact skin exposure, and percutaneous injury (occurs as a result of a break in the skin caused by a needle stick or sharps contaminated with blood or body fluids) [1][2][3][4][5].…”

“…A recent review stipulated that the prevalence of infections, such as HCV is significantly higher in HCWs than in the general population [1]. A review by Tavoschi et al in the European Union/European Economic Area also indicate high levels of HBV and HCV infection among specific groups (such as HCWs); estimates varied widely from 0.4 to 11.7% for HBV and from 0.7 to over 90% for HCV with most being higher than in the general population [4].…”

“…Numerous systematic reviews on BBFs exposure, prevalence of blood-borne infections, and the determinant factors were explored so far [ 1 , 4 , 6 – 9 ]. For instant, a review by Auta et al has demonstrated that HCWs who had received training on infection prevention and occupational exposure to blood and body fluids.…”

Estado inmunológico frente a la Hepatitis B del personal sanitario en dos departamentos de salud de la Comunidad Valenciana (España)

“…Por este motivo es necesario la realización de estudios de marcadores serológicos en estos colectivos (23,24) . Además, debemos destacar tal y como se contempla en la Ley de Prevención de Riesgos Laborales (25) , el Estatuto de los trabajadores (26) y el protocolo de vigilancia sanitaria del Ministerio de Sanidad, Consumo y Bienestar Social (27) , específico para todos los trabajadores sanitarios de centros asistenciales, expuestos a agentes biológicos, amparado en el artículo 8 del Real Decreto 664/1997, se establecen las directrices que garantizan la vigilancia y protección del trabajador ante los riegos derivados de su actividad.…”