Hepatitis B antigen and antibody and tests of liver function: a prospective study of 310 hospital laboratory workers.

Abstract

This prospective epidemiological study of a population of hospital laboratory workers, exposed to hepatitis routinely, studied the prevalence of the presence of hepatitis B antigen and antibody (HBsAg and HBsAb, respectively) over a 26-month period among these workers. Tests of liver functions, including measurement of serum bile acids, were also performed. 111 were studied once and 199 employees were measured at least 2 times. Though the prevalence of antigen for hepatitis was 1.7% and that for antibody was 23.9%, the rate of hepatitis attack was only 3% per year, a percentage consistent with the expected sporadic occurrence of hepatitis viral infection in such a population. Attempts were made to isolate risk factors. The following were determined: 1) exposure to body fluids, 2) exposure to body tissue, and 3) increasing duration of employment. Sex was not found to be a significant difference. When information on prior transfusion or attack of hepatitis was elicited from the study population, those with 1 or the other showed a much higher prevalence of Hb marker; this prevalence of marker increased if both transfusion and hepatitis viral attack had occurred in the past. However, the clinical significance of a positive HB marker with or without other risk factors (including alcohol ingestion and use of oral contraceptives) was negligible. It was found that the prevalence figures of hepatitis antibody underestimate the incidence of hepatitis infection. Liver function tests were routinely normal in all cases (i.e., with or without previous hepatitis infection or presence of antibody or marker) except where acute hepatitis infection was present. The spread of hepatitis among laboratory personnel is not considered a great public health hazard.