Viral hepatitis in health care personnel at The Johns Hopkins Hospital. The seroprevalence of and risk factors for hepatitis B virus and hepatitis C virus infection.

ABSTRACT

BACKGROUND: Health care personnel are at increased risk of occupational acquisition of hepatitis B virus (HBV) infection. While effective vaccination for HBV is widely available, the prevalence of HBV and vaccine acceptance in hospital personnel have not been recently assessed. In addition, hepatitis C virus (HCV) is a newly recognized cause of parenterally acquired hepatitis, and the risk of HCV transmission to health care personnel remains unclear. METHODS: From April to December 1991, health care personnel at The Johns Hopkins Hospital, Baltimore, Md, were offered anonymous testing for HBV and HCV and were asked to complete a confidential questionnaire. Serum samples were tested for HBV surface antigen and antibodies to HBV core antigen, HBV surface antigen, and HCV. Seroprevalence rates were compared with those detected in local blood donors during the same year. RESULTS: Antibodies to HBV core antigen were found in 59 (6.2%) of 943 health care workers compared with 1879 (1.8%) of 104,239 local blood donors (P < .001). In contrast, antibodies to HCV were found in seven (0.7%) of 943 health care workers and 0.4% of local blood donors (P = .10). Infection with HBV was associated with age (> or = 33 years) (P < .001), black race (P < .001), type of health care worker (nurse) (P = .02), 10 ore more years of clinical employment (P = .003), and lack of HBV vaccination (P < .001). After logistic regression, only absence of HBV vaccination was independently associated with HBV infection (P < .001). CONCLUSION: These data suggest that the prevalence of HCV infection in health care personnel at The Johns Hopkins Hospital is similar to that observed in local blood donors, and that HBV may be more efficiently transmitted than HCV in the health care setting. Efforts to vaccinate health care personnel against HBV should be vigorously pursued since 23% remain unvaccinated after 9 years of HBV vaccine availability.