Fluctuation of Viremia in Hepatitis B Virus–Infected Healthcare Workers Performing Exposure-Prone Procedures in the Netherlands. (20th May 2016)

• Record Type: Journal Article
• Authors: Raven, Stijn F. H.; de Heus, Barry; Wong, Albert; Zaaijer, Hans L.; van Steenbergen, Jim E.
• Is Part Of: Infection control and hospital epidemiology. Volume 37:Number 6(2016)
• Page Start: 655
• Page End: 660
• Publication Date: 2016-05-20
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2016.49
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract : Objective: To determine the longitudinal changes in viral load of hepatitis B virus (HBV)–infected healthcare workers (HCWs) and its consequences for exclusion of infected HCWs performing exposure-prone procedures, various HBV DNA safety thresholds, and the frequency of monitoring. Design: Retrospective cohort study June 1, 1996–January 31, 2013. Participants: In the Netherlands, chronically HBV-infected HCWs performing exposure-prone procedures are notified to the Committee for Prevention of Iatrogenic Hepatitis B. Of the 126 notified HCWs, 45 had 2 or more HBV DNA levels determined without antiviral therapy. Methods: A time-to-event analysis for HBV-infected HCWs categorized in various viremia levels surpassing a HBV DNA threshold level of 1×10 5 copies/mL, above which exposure-prone procedures are not allowed in the Netherlands. Results: Fluctuations of HBV DNA in follow-up samples ranged from −5.4 to +2.2 log10 copies/mL. A high correlation was seen for each HBV DNA level with the 3 previous levels. In a time-to-event analysis, after 6 months 7.2%, 6.5%, and 14.3% of individuals had surpassed the threshold of 1×10 5 copies/mL for viral load categories 4.8×10 3 to 1.5×10 4 ; 1.5×10 4 to 4.0×10 4 ; and 4.0×10 4 to 1.0×10 5, respectively. Conclusions: We propose standard retesting every 6 months, with more frequent retesting just below the high threshold value (1×10 5 copies/mL), and prolonging this standard interval to 1 year after 3 consecutive levels below the threshold in policies with lower safety thresholds (1×10 3 or 1×10 4 copies/mL). Infect Control Hosp Epidemiol 2016;37:655–660