Incidence of Parenterally Transmitted Acute Viral Hepatitis Among Healthcare Workers in Italy

Abstract

In Italy during 1995-2004, no significant difference was observed in the incidence rate of acute hepatitis B virus infection in the general population and in healthcare workers, with a downward trend noted in both groups. In contrast, the incidence rate of acute hepatitis C virus infection was significantly higher in healthcare workers than in the general population. In Italy, despite the strong recommendation since 1985 for healthcare workers (HCWs) to receive the hepatitis B virus (HBV) vaccine , the incidence of hepatitis B in HCWs continued to be higher than that in the general population during 1986-1991, likely reflecting poor vaccination coverage. Hepatitis C virus (HCV) is less infective than HBV. Studies published between 1992 and 2002 involving more than 11,000 HCV-exposed HCWs in 6 countries indicate that the average rate of HCV transmission after a single needlestick exposure is 0.5%. According to the Studio Italiano Rischio Occupazionale da HIV, a nationwide study on the occupational risk of acquiring human immunodeficiency virus (HIV) in Italy, the largest and most standardized study in the world, since 1995 there have been 3,795 exposures to anti-HCV–positive patients and a transmission rate as low as 0.4%. This rate increases to 0.9% in exposures with large inocula (eg, from hollow needles full of blood), whereas it is 0.3% for conjunctival exposure. Similar to hepatitis B, the incidence of acute hepatitis C in Italy during 1991-1994 was significantly higher in HCWs than in the general population. The Sistema Epidemiologico Integrato dell’Epatite Virale Acuta (SEIEVA) is Italy’s national surveillance system for acute viral hepatitis, which has been operating since 1985. Using SEIEVA data, we evaluated the incidence trends of acute hepatitis B and hepatitis C in HCWs and compared the incidence of these 2 infections in HCWs and members of the general population of the same age during 1995-2004. The SEIEVA data also served as the basis for the previously performed evaluations.