Abstract
Hepatitis B virus (HBV) infection is a global health problem with an estimated 257 million chronically infected people. Indonesia is a moderately hepatitis B-endemic country with 7.1% prevalence of hepatitis surface antigen (HBsAg). This infection is considered as an important occupational hazard among health care workers (HCWs), who may become further transmitters of this infection. The extent of hepatitis B among HCWs and specific control strategy are not available in Indonesia. A study was done on 644 HCWs, who were categorized into administration, nonintervention, and intervention groups. The prevalence of HBsAg, antibody to HBV core antigen (anti-HBc), and antibody to HBsAg (anti-HBs) was 4.7, 18.5, and 36.7% respectively, while 57.3% were negative for all seromarkers, indicating susceptibility to this infection. Increasing trend with age was observed in the exposure to infection (anti-HBc) (p <0.001) and the marker of resolved infection (HBsAg-, anti-HBc+, anti-HBs+) (p = 0.004), suggesting accumulated exposure to HBV infection by increasing age. Rising trend of exposure rate was also observed across the administration, nonintervention, and intervention groups (p < 0.001). By length of service period, significant escalation of exposure (p = 0.010) and resolved infection (p < 0.001) were also observed, suggesting increasing occupational risk to HBV infection. There is an urgent need to safeguard the HCWs with hepatitis B vaccination and provide continuing education at various health care setups. The establishment of a national policy and a roadmap for effective and efficient intervention is required for the prevention, diagnosis, postexposure management, and treatment of HBV infection in this special population.How to cite this article: Muljono DH, Wijayadi T, Sjahril R. Hepatitis B Virus Infection among Health Care Workers in Indonesia. Euroasian J Hepato-Gastroenterol 2018;8(1):88-92.
Highlights
The global prevalence of Hepatitis B virus (HBV) infection in the general population is estimated to be at 3.5% with about 257 million people living with chronic HBV infection
Efforts to collect data for HBV infection among health care personnel in Indonesia have been made by the Subdirectorate of Hepatitis and Gastrointestinal infection, Directorate of Direct Communicable Diseases, Ministry of Health, Republic of Indonesia, which examined the prevalence of HBsAg among 60,000 health care workers (HCWs) from 12 provinces in Indonesia.[13]
Considering the high exposure rates to HBV infection, HCWs highly need vaccination in order to be protected. This is in line with the recent World Health Organization (WHO) updated position paper on hepatitis B vaccine—July 2017, which recommends that HCWs and other groups with occupational exposure should be the targets for vaccination
Summary
The global prevalence of HBV infection in the general population is estimated to be at 3.5% with about 257 million people living with chronic HBV infection This infection accounts for 887,000 annual deaths due to its complications, including cirrhosis and hepatocellular carcinoma.[1] Indonesia with a total population of more than 250 million people has 7.1% prevalence of HBsAg, and, is classified as a moderately hepatitis B-endemic country.[2]. Several groups have been assigned as special populations who have particular risks for acquiring HBV infection Among those are HCWs who are at high risk of occupational hazard, and may further transmit this virus to patients and their families.[3,4] It has been shown that HCWs have an up to four-fold incidence of this infection in the general population. Prevalence and risk factors of HBV infection in HCWs, and describes the need to mount a nationwide policy for the prevention, control, and management of hepatitis B in HCWs
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