Hepatitis B and C status among health care workers in the five main hospitals in eastern Libya

Abstract

The aim of the present study was to determine the frequency of hepatitis B and C transmission to health care workers (HCWs) in five major hospitals in eastern Libya and to analyze how the risk of these infections are affected by the type of occupation, hospital work place and working period. From July 2008 to June 2009, 601 HCWs (mean age: 32.90 ± 8.85 years) were tested for HBV and HCV markers using ELISA techniques. Polymerase chain reaction (PCR) was performed on all positive samples of HBsAg and Anti-HCV antibody to determine the level of HBV-DNA and HCV-RNA viremia, respectively. The overall frequency of HBsAg positivity was 1.8%. Anti-HBc, HBeAg and Anti-HBe antibodies were found in 8.5%, 0.7% and 8.0% of samples, respectively. The HBV-DNA level was positive in 55% of all HBsAg-positive samples. Approximately half of the HCWs (51.4%) were Anti-HBs antibody positive. The overall positivity rate of Anti-HCV antibodies was 2.0%, and HCV-RNA was positive in 33.3% of these samples. Overall, 52% of HCWs reported receiving full vaccination doses (three doses) against HBV infection. Among them, anti-HBs positivity was approximately 98.0%. 3.9% of those who never received any HBV vaccination dose were HBsAg positive, compared to 1.3% HBsAg positive in those HCWs who had received one or two doses of hepatitis B vaccine (p=0.01 for all comparisons). Nurses and nurse-aides had the highest rates of both HBsAg and Anti-HCV among the studied HCWs (HBsAg: 2.1% and 3.2%; Anti-HCV: 3.2% and 4.9%, respectively). It is noteworthy that doctors also had a relatively high prevalence rate of Anti-HCV (2.2%). Obstetric wards, isolation room, dialysis units and dentist work places had higher frequencies of HBV. HCV was found to be higher in the medical and surgical wards (the prevalence varied between 3% and 5.6%). There was no significant difference between HBsAg status and the work period of HCWs. In conclusion, universal precautions should be applied for the care of all patients by all HCWs. Further, HBV vaccines should be more readily available for Libyan HCWs by reinforcing current vaccination programs.

Hepatitis B virus and hepatitis C virus infection in healthcare workers

“…The characteristics of the wound received by a healthcare worker and the volume of blood transferred are other main factors influencing a possible transmission of HBV or HCV infection. In fact, the devices Elzouki et al [54] 2008 Libya 601 Cross-sectional 12 (2) Alqahtani et al [55] NR Saudi Arabia 300 Cross-sectional 0 Arguillas et al [56] 1990…”

“…Rehman et al [66] , in a small case-control study performed in Pakistan, enrolled 95 healthcare workers and 91 volunteer blood donors as controls and observed higher rates of HBsAg (14% vs 5%) and anti-HBc (36% vs 28%) positivity in the control group. Instead, in a case-control study conducted in Turkey [64] , the rate of HBsAg positivity was similar in 702 healthcare workers and 5670 blood donors (3% vs 2.1%), and in the Philippines, Arguillas et al [56] found 6.5% of 123 healthcare workers and 2.2% of 382 blood donors to be Elzouki et al [54] 2008 Libya 601 Cross-sectional 11 (1.8) 51 (8.5) Alqahtani et al [55] NR Saudi Arabia 300 Cross-sectional 1 (0.3) 25 (8) Arguillas et al [56] 1990…”

“…In a study performed in Lybia in 2008 on 601 healthcare workers, the rate of HBsAg positivity was 1.8%, higher in nurses (2.3%) and lower in physicians (0.7%) and laboratory staff (0.8%) [54] . Of 237 healthcare workers tested in Cameroon, 6.3% were HBsAg-positive and 73.4% anti-HBc-positive, in accordance with the wide spread of HBV infection in this geographical area [60] .…”

“…The rates of HBsAg and anti-HBc positivity in healthcare workers reported in several studies published in the last three decades [54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70] range from 0.1% to 8.1% and from 6.2% to 73.4%, respectively, depending on the age of the subjects investigated, the spread of HBV infection in their country of origin and on the prevention strategies used by the healthcare workers (Table 1). Of 5813 healthcare workers tested in Italy in 1985, 21.5% were found to be anti-HBc-positive and 1.8% HBsAg-positive [65] .…”

Viral Hepatitis Prevalence in Two Cognitively Different Risk Groups

“…A study conducted in South Korea with 571 HCWs, reported HBsAg positivity to be 2.4% and anti-HBs positivity 76.9%, and that these rates were not different from that of the general population (20). In another study conducted with 601 HCWs, HBsAg positivity was found 1.8%, and anti-HBs positivity 51.4%; and anti-HBs positivity was identified in laboratory technicians (63.6%), doctors (62.7%), nurses (52%) and cleaning personnel (40%) (21).…”