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Abstract Details
Clinical and occupational health management of healthcare workers living with chronic hepatitis B: UK policy and international comparisons
J Viral Hepat. 2021 Mar 4. doi: 10.1111/jvh.13494. Online ahead of print.
Grace E Dolman1, Apostolos Koffas2, Emily Phipps3, Patrick T F Kennedy1
Author information
1Barts Liver Centre, Blizard Institute, The London School of Medicine and Dentistry, Queen Mary University of London, Barts, London, UK.
2Department of Gastroenterology, General University Hospital of Larisa, Larisa, Greece.
3Blood Safety, STI and HIV Division, National Infection Service, Public Health England, London, UK.
Abstract
Hepatitis B virus (HBV) is a highly infectious blood-borne virus, which remains endemic in large geographic areas and represents a major global healthcare challenge. HBV transmission from healthcare workers, who perform exposure prone procedures (EPP), to patients is a recognised transmission risk, which varies widely globally. Although the risk is small in developed countries, it increases significantly in high-prevalent, low-resource countries, representing a major challenge to these healthcare systems and underlining the necessity for robust guidance to be in place. The HBV landscape has evolved as a result of global vaccination programs, implementation of standard precautions and the advent of new generation antiviral agents (3rd generation nucleos(t)ide analogues). In light of the progress in the field, the UK Advisory Panel for Healthcare Workers Infected with Blood Borne Viruses (UKAP) recently issued updated guidance, which essentially removes past barriers, restricting healthcare workers from performing EPPs solely on the basis of HBV DNA level, regardless of hepatitis B 'e' antigen and/or treatment status. Although the current recommendations remain conservative compared to those of other developed healthcare systems, UK practice is now in line with other high-income countries, while ensuring patient safety remains paramount, without unduly restricting HCWs from clinical practice. The current article presents the latest UKAP guidance, considers its implications for HCWs and compares it with the guidance from major international scientific societies and governing bodies.