Thomas L. Lewis

A Comparison of the Frequency of Hepatitis-B Antigen and Antibody in Hospital and Nonhospital Personnel

Abstract The frequency of hepatitis B antigen and antibody among health-care personnel was compared with that among matched controls with no exposure to patients or blood products. The frequency of the antigen in personnel and controls did not differ significantly. However, the causes may have been different, the antigen correlating with past transfusion in the controls but not in personnel. A history of past hepatitis did not correlate with antigenemia in either population, impugning the validity of hepatitis history as a cause for donor exclusion. Antibody was twice as frequent in health personnel, indicating increased exposure to the antigen; antibody correlated with past hepatitis in personnel, but not in controls, suggesting that overt hepatitis B infection is more common among health personnel. The frequency of hepatitis B antigen among health workers is not currently alarming, but the risk that each antigen-positive health worker represents to his patients remains unknown. (N Engl J Med 289:647–651...

Health-care workers positive for hepatitis B surface antigen. Are their contacts at risk?

To assess the hepatitis risk to patients exposed to HBs AG-positive health-care workers, 228 contacts were followed prospectively for six to nine months. Health workers included two physicians with chronic hepatitis, a chronic asymptomatic carrier nurse, a food handler with acute HBs Ag-positive hepatitis and a physician who was HBs Ag-positive for 25 days before the onset of acute hepatitis. Controls (167) consisted of identically followed patients who had not been exposed to an HBs Ag-positive health worker. No exposed or control patient acquired clinical hepatitis or HBs Ag. Isolated elevations in serum glutamic pyruvic transaminase occurred equally in both groups and did not correlate with serologic evidence for hepatitis B infection. One exposed patient demonstrated antibody seroconversion (anti-HBs), as did two of the controls. These data do not demonstrate hepatitis B transmission from HBs Ag-positive health workers to their patients. Restriction of such carriers is not warranted at present.