Hepatitis B in the Cambridge dialysis and transplant unit 1966-1983

Area of Science:

• Hepatology
• Infectious Diseases
• Nephrology

Background:

• Hepatitis B virus (HBV) poses a significant risk in healthcare settings, particularly for immunocompromised patients.
• Dialysis and transplant patients are at increased risk of HBV infection due to their clinical status and frequent healthcare interactions.

Purpose of the Study:

• To report the results of hepatitis B surveillance in Cambridge dialysis and transplant units.
• To assess the prevalence of hepatitis B infection markers in haemodialysis patients.
• To identify sources and transmission routes of hepatitis B within the units.

Main Methods:

• Surveillance of hepatitis B markers (anti-HBc, HBsAg) in patients and staff.
• Review of patient admission and transplantation data.
• Exclusion of pre-existing carriers through preadmission screening.

Main Results:

• 34/528 (6.44%) of haemodialysis patients had anti-HBc on admission.
• 19 HBsAg carrier patients and 2 carrier staff were excluded by preadmission screening.
• Eight patients became antigenaemic post-admission; two others were identified post-transplantation.
• Of the newly infected patients, seven had asymptomatic carriage and one had acute hepatitis during haemodialysis.
• No cross-infection was observed within the dialysis or transplant units.
• One staff member acquired infection accidentally from an outpatient.

Conclusions:

• Hepatitis B surveillance is crucial in dialysis and transplant units.
• While no unit cross-infection occurred, vigilance is needed to prevent transmission.
• External sources, like outpatients, can pose a risk to healthcare staff.