Why is hep B vaccination of doctors and nurses not yet universal in all health facilities?
HEPATITIS B IN HEALTHCARE WORKERS: TRANSMISSION EVENTS AND GUIDANCE FOR MANAGEMENT

Lewis JD¹, Enfield KB¹, Sifri CD¹.

Author information

• ¹Jessica D Lewis, Costi D Sifri, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, United States.

World J Hepatol. 2015 Mar 27;7(3):488-97. doi: 10.4254/wjh.v7.i3.488.

Abstract below; full text is at

http://www.wjgnet.com/1948-5182/full/v7/i3/488.htm

Hepatitis B virus (HBV) is the most efficiently transmissible of the bloodborne viruses that are important in healthcare settings. Healthcare workers (HCWs) are at risk for exposure to HBV from infected patients and, if infected, are similarly at risk of transmitting HBV to patients. Published cases of HBV transmission from HCW to patient are relatively rare, having decreased in frequency following the introduction of standard (universal) precautions, adoption of enhanced percutaneous injury precautions such as double-gloving in surgery, and routine HBV vaccination of HCWs. Here we review published cases of HCW-to-patient transmission of HBV, details of which have helped to guide the creation of formal guidelines for the management of HBV-infected HCWs. We also compare the publisheicd guidelines for the management of HBV-infected HCWs from various governing bodies, focusing on their differences with regard to vaccination requirements, viral load limits, frequency of monitoring, and restrictions on practice. Importantly, while there are differences among the recommendations from governing bodies, no guidelines uniformly restrict HBV-infected HCWs from performing invasive or exposure-prone procedures.