Published online Mar 27, 2015. doi: 10.4254/wjh.v7.i3.488
Peer-review started: September 3, 2014
First decision: November 19, 2014
Revised: November 22, 2014
Accepted: December 16, 2014
Article in press: December 16, 2014
Published online: March 27, 2015
Hepatitis B virus (HBV) is the most efficiently transmissible of the bloodborne viruses that are important in healthcare settings. Healthcare workers (HCWs) are at risk for exposure to HBV from infected patients and, if infected, are similarly at risk of transmitting HBV to patients. Published cases of HBV transmission from HCW to patient are relatively rare, having decreased in frequency following the introduction of standard (universal) precautions, adoption of enhanced percutaneous injury precautions such as double-gloving in surgery, and routine HBV vaccination of HCWs. Here we review published cases of HCW-to-patient transmission of HBV, details of which have helped to guide the creation of formal guidelines for the management of HBV-infected HCWs. We also compare the published guidelines for the management of HBV-infected HCWs from various governing bodies, focusing on their differences with regard to vaccination requirements, viral load limits, frequency of monitoring, and restrictions on practice. Importantly, while there are differences among the recommendations from governing bodies, no guidelines uniformly restrict HBV-infected HCWs from performing invasive or exposure-prone procedures.
Core tip: Reports of transmission of hepatitis B virus (HBV) from infected healthcare workers (HCWs) to patients have been rare but are highly instructive when they do occur. These events have helped instruct formal recommendations for the management of HBV-infected HCWs. However, guidelines from various governing bodies differ in their recommendations for the monitoring of infected HCWs, as well as in their restriction of the practice of invasive, exposure-prone procedures.