The risk of contracting HBV by health care workers (HCW) is four-times greater than that of general adult population. Studies have demonstrated that vaccine-induced protection persists at least 11 years. High risk groups such as HCWs should be monitored and receive a booster vaccination if their anti-HBsAb levels decrease below 10？mIU/mL. In view of the above this study was undertaken to assess the HBV vaccination of the HCWs and their immunological response. Seventy-two HCWs of the Department of Microbiology, Maulana Azad Medical College, New Delhi, India, were recruited and blood sample was drawn for serological tests (HBSAg, anti-HCV, anti-HBsAb, anti-HBeAb, and anti-HBcAb). Anti-HBs titers of >10？mIU/mL were considered protective. Thirty-four (47.3%) of the participants were completely vaccinated with three doses. 25 (73.5%) of the participants with complete vaccination had protective anti-HBsAb levels as against 8 (53.3%) of those with incomplete vaccination and 9 (39.1%) of those who were not vaccinated at all. One of our participants was acutely infected while 29 participants were susceptible to infection at the time of the study. All HCWs should receive three doses of the vaccine and be monitored for their immune status after every five years. Boosters should be administered to those who become susceptible. 1. Introduction Hepatitis B is a serious infectious disease of the liver which affects millions of people worldwide. More than 2 billion people living today have been infected with Hepatitis B virus (HBV) at some time in their lives and about 350 million people are carriers of the virus [1]. India has intermediate endemicity of Hepatitis B, with Hepatitis B surface antigen (HBsAg) prevalence between 2% and 7%. The number of HBsAg carriers in India has been estimated to be over 50 millions [2, 3]. Throughout the world, millions of healthcare professionals work in health institutions and it is estimated that 600,000 to 800,000 cut and puncture injuries occur among them per year, of which approximately 50% are not registered [4]. The risk of contracting HBV by health care workers (HCWs) is four-times greater than that of general adult population [5]. The highest rates are seen among dentists, physicians, laboratory workers, dialysis workers, cleaning service employees, and nurses [6]. Blood contains the highest HBV titers of all body fluids and is the most important vehicle of transmission in the health care setting. Avoiding occupational blood exposure is the primary preventive means for the transmission of HBV. Immunization and after exposure
References
[1]
F. Averhoff, F. Mahoney, P. Coleman, G. Schatz, E. Hurwitz, and H. Margolis, “Immunogenicity of hepatitis B vaccines: implications for persons at occupational risk of hepatitis B virus infection,” American Journal of Preventive Medicine, vol. 15, no. 1, pp. 1–8, 1998.
[2]
E. B. Byrne, “Viral hepatitis: an occupational hazard of medical personnel. Experience of the Yalenew Haven Hospital, 1952 to 1965,” Journal of the American Medical Association, vol. 195, no. 5, pp. 362–364, 1966.
[3]
CDC. Morbidity Mortality Weekly Reports. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis, pp. 1–42, 2001, http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm.
[4]
L. A. S. Ciorlia and D. M. T. Zanetta, “Hepatitis B in healthcare workers: prevalence, vaccination and relation to occupational factors,” Brazilian Journal of Infectious Diseases, vol. 9, no. 5, pp. 384–389, 2005.
[5]
E. Dannetun, A. Tegnell, A. Torner, and J. Giesecke, “Coverage of hepatitis B vaccination in Swedish healthcare workers,” Journal of Hospital Infection, vol. 63, no. 2, pp. 201–204, 2006.
[6]
EPINET, “Needle stick prevention devices,” Health Devices, vol. 28, pp. 381–407, 1999.
[7]
European Consensus Group on Hepatitis B Immunity, “Are booster immunizations needed for lifelong hepatitis B immunity?” The Lancet, vol. 355, pp. 561–565, 2000.
[8]
D. FitzSimons, G. Fran？ois, G. De Carli et al., “Hepatitis B virus, hepatitis C virus and other blood-borne infections in healthcare workers: guidelines for prevention and management in industrialised countries,” Occupational and Environmental Medicine, vol. 65, no. 7, pp. 446–451, 2008.
[9]
S. Gupta, R. Gupta, Y. K. Joshi, and S. Singh, “Role of horizontal transmission in hepatitis B virus spread among household contacts in north India,” Intervirology, vol. 51, no. 1, pp. 7–13, 2008.
[10]
S. Plotkin, E. Leuridan, and P. Van Damme, “Hepatitis B and the need for a booster dose,” Clinical Infectious Diseases, vol. 53, no. 1, pp. 68–75, 2011.
[11]
F. J. Mahoney, K. Stewart, H. Hu, P. Coleman, and M. J. Alter, “Progress toward the elimination of hepatitis B virus transmission among health care workers in the United States,” Archives of Internal Medicine, vol. 157, no. 22, pp. 2601–2605, 1997.
[12]
M. Saberifiroozi, S. Gholamzadeh, and A. R. Serati, “The long-term immunity among health care workers vaccinated againts hepatitis B virus in large referral hospital in southern Iran,” Archives of Iranian Medicine, vol. 9, no. 3, pp. 204–207, 2006.
[13]
K. A. Sepkowitz, “Occupationally acquired infections in health care workers: part II,” Annals of Internal Medicine, vol. 125, no. 11, pp. 917–928, 1996.
[14]
G. Singh, M. P. Singh, I. Walia, C. Sarin, and R. K. Ratho, “Screening for hepatitis B and C viral markers among nursing students in a tertiary care hospital,” Indian Journal of Medical Microbiology, vol. 28, no. 1, pp. 78–79, 2010.
[15]
V. Singhal, D. Bora, and S. Singh, “Hepatitis B in health care workers: Indian scenario,” Journal of Laboratory Physicians, vol. 1, no. 2, pp. 41–48, 2009.
[16]
V. Singhal, D. Bora, and S. Singh, “Prevalence of hepatitis B virus infection in healthcare workers of a tertiary care centre in India and their vaccination status,” Journal of Vaccines & Vaccination, vol. 2, no. 2, p. 118.
[17]
Sukriti, N. T. Pati, A. Sethi et al., “Low levels of awareness, vaccine coverage, and the need for boosters among health care workers in tertiary care hospitals in India,” Journal of Gastroenterology and Hepatology, vol. 23, no. 11, pp. 1710–1715, 2008.
[18]
G. Quaglio, F. Lugoboni, S. Vento et al., “Isolated presence of antibody to hepatitis B core antigen in injection drug users: do they need to be vaccinated?” Clinical Infectious Disease, vol. 32, no. 10, pp. E143–E144, 2001.
[19]
B. J. McMahon, A. J. Parkinson, C. Helminiak et al., “Response to hepatitis B vaccine of persons positive for antibody to hepatitis B core antigen,” Gastroenterology, vol. 103, no. 2, pp. 590–594, 1992.
