Prevalence of HBV & HCV Infection and Adequacy of HBV Vaccination among Healthcare Workers - A Sero Epidemiological Survey and Knowledge, Attitude & Practice (KAP) Study

Abstract

Background: Health Care Workers (HCWs) acquiring hepatotropic blood borne viral infections from work place is common. HCWs should be aware of health consequences, safety practices, preventive strategy and post exposure prophylaxis pertaining to these blood borne infections.

Methods: We evaluated the awareness of HCWs (Doctors, Nurses, Paramedical staff) on mode of transmission, health consequences of infection, preventive and therapeutic options available for Hepatitis B and C using a structured K.A.P. questionnaire (Knowledge, Attitude and Practice). Sero virological assessment to identify the prevalence of HBV and HCV infections were carried out-HBsAg, AntiHBc (total core) and anti HCV.HBV vaccination status was also assessed by history of vaccination and serological assessment of anti HBs titers.

Results: 98% of participants were aware of health consequences of an accidental exposure and were concerned about follow up. Four (0.8%) were found to be anti HCV positive but turned out to be RNA negative. None were HBsAg positive. Protective (>10 IU/mL) anti-hepatitis B surface (anti-HBs) antibody titers were seen in 86%. 83.7% had taken all three doses but only 34% had checked Anti HBS titer after full course of vaccination. Protective antiHBc titres did not wane of even in those with >25 years of practice after vaccination. Surprisingly more proportion of nurses (93.5%) as compared to doctors (72.4%) was fully vaccinated.

Conclusion: Most of the Health Care workers (98%) were aware of occupational risks of HBV and HCV infections and also were aware of significance of HBV vaccination but only 34% received complete HBV vaccination by definition. The need to check anti HBs titer after completing the course of vaccination has to be stressed, since in the event of accidental exposure whether to administer hepatitis B immunoglobulin depends on post vaccination antibody titers. There is need to ensure mandatory vaccination against HBV infection among HCWs and ensure complete and consistent adherence to standard safety measures as well as post exposure prophylaxis protocols pertaining to HBV and HCV in the workplace.