Viral hepatitis in South African healthcare workers at increased risk of occupational exposure to blood-borne viruses

Nurses at risk for occupationally acquired blood-borne virus infection at a South African academic hospital

“…19 At that time recommendations were made for a cost-effective approach to the prevention and management of viral hepatitis in HCWs. 20 Our follow-up study at the same hospital a decade later indicates that, at most, only 52.4% of the nurses are now protected against HBV infection. However, as many as 28.6% of these nurses were anti-HBc-positive indicating that they had acquired the infection naturally.…”

“…21 Response rates to HB vaccination in HIV-infected individuals are as low as 18 -62%, and a CD4 count <200 has been shown to be an independent predictor of reduced response. 20 These factors could explain why 4 of the 5 nurses who were HIV positive and gave a history of recent vaccination were non-responders or low-responders, with antiHBs titres of ≤55 mIU/ ml. It is suggested that HB …”

“…At an academic hospital in Johannesburg in 1996, among 402 HCWs, of whom 80.6% were blacks and 19.4% whites, 30.6% had HBV antibodies and 1.8% tested positive for HCV antibodies. 20 In Denmark, where the prevalence of blood-borne viral infections is low, the prevalence of HIV, HCV and HBV was 0%, 0.14% and 1.6% respectively among HCWs in an academic hospital. 21 Our purpose was to re-examine the nurses working predominantly in the medical wards of the same academic hospital in Johannesburg 20 to re-assess the prevalence of occupational viral infections.…”

“…Vardas et al 20 presented an extensive series of recommendations for the prevention of hepatitis A, B and C in South African HCWs. However, this study, essentially 10 years later, shows that in the same institution HCWs remain at high risk.…”

Should routine serological screening for HCV be mandatory in HIV/AIDS patients enrolling for HAART in South Africa?

“…1 In Africa, HCV prevalence ranges from <3% in South Africa to >20% in Egypt. In South Africa, there is a low prevalence from 0.16% to 1.8%, [2][3][4][5] but this is higher in high-risk individuals, e.g. 39.4% in haemophiliacs and 4.8% in chronic dialysis patients.…”