ABSTRACT
Hepatitis B virus (HBV) infection is a global health problem with an estimated 257 million chronically infected people. Indonesia is a moderately hepatitis B-endemic country with 7.1% prevalence of hepatitis surface antigen (HBsAg). This infection is considered as an important occupational hazard among health care workers (HCWs), who may become further transmitters of this infection. The extent of hepatitis B among HCWs and specific control strategy are not available in Indonesia. A study was done on 644 HCWs, who were categorized into administration, nonintervention, and intervention groups. The prevalence of HBsAg, antibody to HBV core antigen (anti-HBc), and antibody to HBsAg (anti-HBs) was 4.7, 18.5, and 36.7% respectively, while 57.3% were negative for all seromarkers, indicating susceptibility to this infection. Increasing trend with age was observed in the exposure to infection (anti-HBc) (p <0.001) and the marker of resolved infection (HBsAg-, anti-HBc+, anti-HBs+) (p = 0.004), suggesting accumulated exposure to HBV infection by increasing age. Rising trend of exposure rate was also observed across the administration, nonintervention, and intervention groups (p < 0.001). By length of service period, significant escalation of exposure (p = 0.010) and resolved infection (p < 0.001) were also observed, suggesting increasing occupational risk to HBV infection. There is an urgent need to safeguard the HCWs with hepatitis B vaccination and provide continuing education at various health care setups. The establishment of a national policy and a roadmap for effective and efficient intervention is required for the prevention, diagnosis, postexposure management, and treatment of HBV infection in this special population. How to cite this article: Muljono DH, Wijayadi T, Sjahril R. Hepatitis B Virus Infection among Health Care Workers in Indonesia. Euroasian J Hepato-Gastroenterol 2018;8(1):88-92.
ABSTRACT
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections pose serious problems in terms of public health and clinical intervention in a country with approximately 250 million people, who live in more than 17,000 islands. Efforts to combat HBV and HCV have been made through the implementation of universal infant hepatitis B immunization, blood screening, and other health promotion actions, and building epidemiological data to develop intervention strategies. A nationwide study in 2013 revealed hepatitis B surface antigen (HBsAg) prevalence of 7.1%, which indicates that Indonesia has moved from high to moderate endemicity of hepatitis B, leaving the prevalence of 9.4% in 2007. The occurrences of new hepatitis B cases still continue in early childhood period, which may root from low coverage of birth-dose hepatitis B immunization in remote islands, and the potential mother-to-child transmission of HBV from HBsAg-positive pregnant mothers. Other problems still exist including the high HBV infection rates among young adults in remote islands, the presence of occult hepatitis B, as well as the substantial prevalence of HCV infection in general population, who do not have access to diagnosis and treatment. Effective preventive and control strategies are being developed tailored to the local capacity, infrastructures, socioeconomics, and culture, as well as geographical aspects of the country. How to cite this article: Muljono DH. Epidemiology of Hepatitis B and C in Republic of Indonesia. Euroasian J Hepato-Gastroenterol 2017;7(1):55-59.
