ABSTRACT
The prevalence of hepatitis B virus (HBV) in healthcare workers (HCW) in Brazilian university hospitals is high. However, vaccination of these workers and relations with occupational factors are not well documented. A prospective study was made of 1,433 HCW and 872 administrative employees of the Hospital de Base (HB), São José do Rio Preto, SP, Brazil, and 2,583 blood donor candidates from the Hospital Blood Bank. HCW were observed from January 1994 to December 1999. Data were obtained from exams made when a worker entered hospital service, periodically and after work-related injuries. Serological reactions were analyzed in HCW who received HBV vaccine. Occupational and non-occupational information was obtained through a questionnaire. The prevalence of HBV among HCW (0.8 percent) was significantly higher than in blood-donor candidates (0.2 percent). Among the HCW who were vaccinated, 86.4 percent were immunized. Multivariate analysis revealed that increased age reduced the chance of immunization. Among the occupational factors, time in service contributed to a 14 percent increase in the chances of having positive serology, and work-related injuries increased the risk of HBV infection 4.29 times. The maximum risk sector presented a larger number of HCW with positive anti-HBc serology. There was a higher seroconversion in HCW who received the full set of HBV vaccines. In HCW with positive serology, the factors that presented greatest risks were time in service, work-related injuries and maximum risk sector.
Subject(s)
Female , Humans , Male , Accidents, Occupational/statistics & numerical data , Blood Donors , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Health Personnel/statistics & numerical data , Hepatitis B Vaccines/therapeutic use , Hepatitis B/epidemiology , Antigen-Antibody Reactions , Biomarkers/blood , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Epidemiologic Methods , Hepatitis B Antibodies/blood , Hepatitis B Antibodies/immunology , Hepatitis B Surface Antigens/blood , Hepatitis B Surface Antigens/immunology , Hepatitis B virus/chemistry , Hepatitis B virus/immunology , Hepatitis B/blood , Hepatitis B/prevention & control , Hospitals, Teaching/statistics & numerical data , Immunization Programs , Occupational Exposure/statistics & numerical dataABSTRACT
En un estudio multicéntrico fueron recolectadas 970 muestras de suero provenientes de personal trabajador del área de la salud. La presencia de marcadores serológicos del VHB (AgsHB, antisuperficie y anticore total) fue analizada mediante técnica de microELISA. Doscientos cuarenta y siete muestras presentaron uno o más marcadores positivos (27%), siendo el marcador prevalente el antisuperficie cuyo índice de positividad resultó significativo en las diferentes áreas consideradas de menor exposición como medicina interna (24.7%). La proporción de muestras antisuperficie positivas fue además significativamenté superior en el grupo con más de 10 años de labor sanitaria en comparación con la prevalencia demostrada por el grupo con menos de 5 años de servicio (19.1 vs 12.8%). Los grupos considerados con menor riesgo de exposición, contrariamente a lo que podría esperarse, demostraron una prevalencia igual e incluso superior a la demostrada en grupos con exposición contínua o frecuente (17.7 vs 8.6%). Nuestros hallazgos sugieren la permanencia ambiental de carga viral circulante del VHB a nivel intrahospitalario venezuelano