NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA.
Clin Liver Dis. 2010 Feb;14(1):119-36; ix-x. doi: 10.1016/j.cld.2009.11.005.
Viral hepatitis was first identified as an occupational hazard for health care workers more than 60 years ago. For the past few decades, hepatitis B has been one of the most significant occupational infectious risks for health care providers. With the increasing prevalence of hepatitis C infections around the world, occupational transmission of this flavivirus from infected patients to their providers has also become a significant concern. Several factors influence the risk for occupational blood-borne hepatitis infection among health care providers, among them: the prevalence of infection among the population served, the infection status of the patients to whom workers are exposed (ie, the source patient's circulating viral burden), the types and frequencies of parenteral and mucosal exposures to blood and blood-containing body fluids, and whether the patient or provider has been immunized with the hepatitis B vaccine. This article reviews patient-to-provider, patient-to-patient, and provider-to-patient transmission of hepatitis B and C in the health care setting. Current prevention strategies, precautions, and guidelines are discussed.
病毒性肝炎早在 60 多年前就被首次确定为医护人员的职业危害因素。在过去的几十年中，乙型肝炎一直是医护人员面临的最重要的职业传染性风险之一。随着全球丙型肝炎感染的流行，这种黄病毒从受感染的患者传播给医护人员的职业传播也成为一个重要的关注点。有几个因素会影响医护人员职业性血源感染肝炎的风险，其中包括：所服务人群的感染流行率、工作人员接触的患者的感染状况（即源患者的循环病毒载量）、接触血液和含血液体液的类型和频率、以及患者或医护人员是否接种过乙型肝炎疫苗。本文综述了医疗保健环境中乙型肝炎和丙型肝炎的患者向医护人员、患者向患者以及医护人员向患者的传播。讨论了当前的预防策略、预防措施和指南。
