Introduction: The practice of anaesthesia involves exposure to blood or bloodstained secretions which may be contaminated with transmissible pathogens including the hepatitis B virus (HBV). This study was undertaken to assess the impact of freely available hepatitis B vaccine and applications of universal precautions against blood exposure on the uptake of immunisation and prevalence of HBV markers in South Africa anaesthesiologists.
Methods: Anaesthesiologists from the Department of Anaesthesia of the University of Natal and those attending a continuing medical education course in Cape Town in March 1993 participated in the study. Each participant completed a questionnaire giving details of previous exposure to HBV, immunisation status and details of immunisation. Blood samples were obtained on a voluntary basis for determination of HBV serology.
Results: One hundred and twenty-one anaesthesiologists participated in the study; 36 were unimmunised, of whom 18 (50%) were seropositive for HBV markers. More experienced anaesthesiologists (> 10 years) tended both not to be immunised and to be seropositive, indicating previous exposure to HBV. Eighty-five participants were immunised. Intradermal immunisation caused significantly less seroconversion than the intramuscular route (35% v. 81%; P < 0.05). Of 7 non-responders to intradermal immunisation, 5 responded to a single intramuscular booster injection.
Discussion: Exposure to HBV is common in anaesthetic practice, as evinced by the 50% seropositivity in unimmunised anaesthesiologists, which means that routine serological testing before immunisation is warranted. Intramuscular immunisation provides the best protection against HBV. Post-immunisation serological testing should be performed to demonstrate an adequate antibody response. The intradermal route may save cost with similar efficacy if combined with post-immunisation testing and a single intramuscular booster injection for non-responders.
Immunisation against hepatitis B viral infection–a study of South African anaesthesiologists
[Category] B형 간염,
[Source] pubmed
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