Hepatitis B infections in a chronic hemodialysis unit in a country where hepatitis B is endemic: a prospective study.

Hepatitis B markers were determined in patients with chronic renal failure and in staff members prior to entry into the hemodialysis unit of a hospital in southern Israel, an area in which hepatitis B is endemic. Patients and staff who were negative for hepatitis B markers were followed for a mean of 26.7 and 29.2 months, respectively, between November 1975 and May 1984. New infections occurred in 25.9% of the patients and 17.3% of the staff; the difference was not statistically significant. Hepatitis B markers were found in 26% of the staff and 41% of the patients (p less than 0.05) prior to their entry into the hemodialysis unit. Furthermore, in the patients, a relatively high rate of carriers was detected (7% compared with 2% in the general population), while no carriers were detected among the staff members. Within the staff group, nurses were at particularly high risk for new infections, accounting for seven of the nine (78%) events recorded. The high risk for the nursing staff is probably due to greater exposure to blood among nurses compared with other staff members.