In:
Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 37, No. 6 ( 2016-06), p. 655-660
Abstract:
To determine the longitudinal changes in viral load of hepatitis B virus (HBV)–infected healthcare workers (HCWs) and its consequences for exclusion of infected HCWs performing exposure-prone procedures, various HBV DNA safety thresholds, and the frequency of monitoring. Design Retrospective cohort study June 1, 1996–January 31, 2013. Participants In the Netherlands, chronically HBV-infected HCWs performing exposure-prone procedures are notified to the Committee for Prevention of Iatrogenic Hepatitis B. Of the 126 notified HCWs, 45 had 2 or more HBV DNA levels determined without antiviral therapy. Methods A time-to-event analysis for HBV-infected HCWs categorized in various viremia levels surpassing a HBV DNA threshold level of 1×10 5 copies/mL, above which exposure-prone procedures are not allowed in the Netherlands. Results Fluctuations of HBV DNA in follow-up samples ranged from −5.4 to +2.2 log 10 copies/mL. A high correlation was seen for each HBV DNA level with the 3 previous levels. In a time-to-event analysis, after 6 months 7.2%, 6.5%, and 14.3% of individuals had surpassed the threshold of 1×10 5 copies/mL for viral load categories 4.8×10 3 to 1.5×10 4 ; 1.5×10 4 to 4.0×10 4 ; and 4.0×10 4 to 1.0×10 5 , respectively. Conclusions We propose standard retesting every 6 months, with more frequent retesting just below the high threshold value (1×10 5 copies/mL), and prolonging this standard interval to 1 year after 3 consecutive levels below the threshold in policies with lower safety thresholds (1×10 3 or 1×10 4 copies/mL). Infect Control Hosp Epidemiol 2016;37:655–660
Type of Medium:
Online Resource
ISSN:
0899-823X
,
1559-6834
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2016
detail.hit.zdb_id:
2106319-9
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