Hlady W G, Hopkins R S, Ogilby T E, Allen S T
Epidemiology Program, Florida Department of Health and Rehabilitative Services, Tallahassee 32399-0700.
Am J Public Health. 1993 Dec;83(12):1689-93. doi: 10.2105/ajph.83.12.1689.
The purpose of the study was to investigate infection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) among patients in a dermatology practice.
Historical cohort, matched case-control, and cross-sectional survey methods were used.
The age-specific incidence of reported HBV infection in the practice from 1985 through 1991 was more than 12 times the expected rate. The dermatologist was not an HBV carrier. He practiced neither universal precautions nor sterile surgical technique. Seroprevalence of markers for HBV infection was highest (36.8%) among patients who had had surgery on the same day that HBV was apparently acquired by an index case; seroprevalence was near the expected background level for patients not exposed to index cases. Of HBV-infected patients with known dates of onset, 72% had had surgery during their incubation periods. All of 30 HBV antigen specimens tested were of the same subtype. None of the patients tested, including 74 patients exposed to surgery on the same day as a patient with acquired immunodeficiency syndrome, had evidence of HIV infection.
HBV, but not HIV, was transmitted from patient to patient by the dermatologist's failure to apply either universal precautions or sterile surgical technique.
本研究旨在调查皮肤科门诊患者中乙型肝炎病毒（HBV）和人类免疫缺陷病毒（HIV）的感染情况。
采用历史性队列研究、匹配病例对照研究和横断面调查方法。
1985年至1991年该门诊报告的HBV感染的年龄别发病率超过预期发病率的12倍。皮肤科医生不是HBV携带者。他既未采取普遍预防措施，也未采用无菌手术技术。在一名指示病例明显感染HBV的同一天接受手术的患者中，HBV感染标志物的血清阳性率最高（36.8%）；未接触指示病例的患者的血清阳性率接近预期背景水平。在已知发病日期的HBV感染患者中，72%在潜伏期接受了手术。所检测的30份HBV抗原标本均为同一亚型。包括74名与获得性免疫缺陷综合征患者同一天接受手术的患者在内，所有接受检测的患者均无HIV感染证据。
由于皮肤科医生未采取普遍预防措施或无菌手术技术，导致HBV在患者之间传播，但未导致HIV传播。
