Department of Occupational Diseases and Toxicology, Nofer Institute of Occupational Medicine, Łódź, Poland,
Int J Occup Med Environ Health. 2013 Jun;26(3):430-9. doi: 10.2478/s13382-013-0088-0. Epub 2013 Jul 1.
Hepatitis B (HBV) and C viruses (HCV) are among the most frequent blood borne pathogens. According to WHO, 5% of healthcare workers (in central Europe), are exposed to at least one sharps injury contaminated with HBV per year, 1,7% - contaminated with HCV.
The aims of the study were to determine prevalence of HCV and HBV infections, vaccination efficacy against hepatitis B and usefulness of alanine aminotransferase (ALT) testing in prophylactic examinations in healthcare workers (HCWs).
In a group of 520 healthcare workers, a survey, laboratory and serologic tests such as ALT, HBsAg, anti-HBs, anti-HBcT and anti-HCV were carried out.
The study revealed a low rate of workers with presence of HBsAg and anti-HCV (1,2% and 0,8% respectively). Anti-HBcT was found in 99 subjects (19%) without a significant association with experiencing an occupational percutaneous injury. Being vaccinated against HBV was declared by 90% of the subjects. There was no relationship between ALT level rise and positive HBsAg, anti-HCV and anti-HBcT tests.
A seroprevalence of HBV and HCV markers in HCWs found in the study is low and similar to the one found in general population. Current or past hepatitis B infections were independent of needle stick injuries. Vaccination against HBV coverage, although found to be high, should improve to 100%. Occupational prophylactic medical examinations found performing ALT test (obligatory in Poland for HCWs) not helpful. It seems that determination of anti-HBcT and anti-HCV status would be essential in pre-employment medical examinations.
乙型肝炎（HBV）和丙型肝炎（HCV）病毒是最常见的血源性病原体之一。根据世界卫生组织的数据，每年有 5%的医护人员（在中欧地区）至少会接触到一次被 HBV 污染的锐器伤，1.7%的医护人员会接触到被 HCV 污染的锐器伤。
本研究旨在确定 HCV 和 HBV 感染的流行率、乙型肝炎疫苗的接种效果，以及丙氨酸氨基转移酶（ALT）检测在医护人员预防性检查中的作用。
在 520 名医护人员中进行了一项调查，同时进行了实验室和血清学检测，如 ALT、HBsAg、抗-HBs、抗-HBcT 和抗-HCV。
研究显示，HBsAg 和抗-HCV 阳性率较低（分别为 1.2%和 0.8%）。99 名受试者（19%）存在抗-HBcT，但与经历职业性经皮损伤无显著关联。90%的受试者表示已接种乙型肝炎疫苗。ALT 水平升高与 HBsAg、抗-HCV 和抗-HBcT 检测结果阳性之间无相关性。
本研究中发现的医护人员 HBV 和 HCV 标志物血清流行率较低，与一般人群相似。目前或既往乙型肝炎感染与针刺伤无关。乙型肝炎疫苗接种覆盖率虽然较高，但应提高到 100%。职业性预防性体检发现，丙氨酸氨基转移酶（ALT）检测（波兰对医护人员的强制要求）并无帮助。在入职前体检中，确定抗-HBcT 和抗-HCV 状态似乎至关重要。
