Hepatitis B virus infection and health care workers

Hepatitis B virus (HBV) infection is the major occupational risk of health care workers, among whom HBV infection risk is 2 to 10-fold elevated above that of the general population. Risk is most clearly related to the degree of direct contact with human blood and body fluids, and to frequency of traumatic exposures in the workplace. Most exposures result from unsuspected asymptomatic HBV carriers, who represent 1 to 2% of hospitalized patients. Risk of HBV infection also varies with the frequency of HBV carriers in the patient population. In the USA, the annual number of new cases has been constant over the last decade, despite a 50% overall increase in acute HBV disease. Control of HBV in the work setting is based on universal precautions for exposure to human blood or body fluids, and hepatitis B vaccination. Increased attention to these recommendations appears to be reducing this problem in the USA.