OBJECTIVES The aim of this study was to assess the rate of and risk factors for exposure to hepatitis B virus (HBV) and hepatitis C virus (HCV) among medical waste handlers.
METHODS
A cross-sectional study was conducted from December 2014 to January 2015. A total of 152 medical waste handlers (MWH) and 82 non-medical waste handlers (NMWH) were studied. Serum samples were collected from participants and screened for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and anti-HCV using rapid immunochromatography assay. MWH were also screened for hepatitis B surface antibody (anti-HBs).
RESULTS
The respective prevalence of HBsAg, anti-HBc and anti-HCV was 1.3%, 39.4%, and 0.7% in MWH, compared to 2.4%, 17.1%, and 1.2%, respectively, in NMWH. Among MWH, 58.6% were susceptible to HBV infection. There was a significant difference in the rate of lifetime exposure to HBV in MWH compared with NMWH (odds ratio [OR], 3.17; 95% confidence interval [CI], 1.64 to 6.13). However, there was no significant difference between participant groups with respect to current HBV infection (OR, 0.53; 95%CI, 0.07 to 3.86) or anti-HCV (OR, 0.54; 95%CI, 0.03 to 8.69). Age older than 40 years and working in a hospital laundry were independent predictors of lifetime exposure to HBV infection. Eleven (7.2%) respondents were vaccinated against HBV.
CONCLUSIONS
Lifetime exposure to HBV infection was significantly higher in MWH than in NMWH. The majority of MWH was not vaccinated against HBV and thus remains susceptible to contracting the infection. Screening upon hire followed by vaccination of MWH is recommended to reduce the transmission of HBV.
Summary
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Summary
Korean summary
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The authors investigated the distribution of Hepatitis C virus (HCV) genotype in blood donors with positive for anti-HCV (n=34), health check-up examiness with positive for anti-HCV (n=29), and in patients with various chronic liver disases positive for anti-HCV (n=63) in Pusan, Korea. HCV genotype was determined by using the molecular typing method through the reverse transcription - polymerase chain reaction (RT - PCR) with four type specific primers. Among 116 anti-HCV positive study subjects, 66.4% were positive HCV RNA by RT-PCR. The major HCV genotype was type II (31.9%) and it was followed by type III (27.6%). Two cases were type IV (1.7%). Double infection with two different HCV genotypes (mixed type) was found in three cases (2.6%).
Three cases (2.6%) were not determined by the four type specific primers, it may have different subtype. Type II was more prevalent than type III in the blood donors and health check-up examinees, but the reverse was true in the chronic liver disease patients including hepatocellular carcinoma patients. Type II was more prevalent than type III among the anti-HCV positive subjects with risk factors such as acupuncture history, surgical operation history, and trans-fusion history. In contrast type III was more prevalent than type II among the subjects without the above risk factors. It is supposed that the pathogenicity of different kind of HCV genotype might be different. The results of this study suggest that the type II and type III may be the major CV genotype in Korea. The differences of HCV genotype distribution between the study groups support that the clinical significance according to the HCV genotype may be different.