The acceptable duration between occupational exposure to hepatitis B virus and hepatitis B immunoglobulin injection: Results from a Korean nationwide, multicenter study - 23/01/16

Doi : 10.1016/j.ajic.2015.08.024

Hyun-Ha Chang, MD ^a, Won Kee Lee, PhD ^a, Chisook Moon, MD ^b, Won Suk Choi, MD ^c, Hee-Jung Yoon, MD ^d, Jieun Kim, MD ^e, Seong Yeol Ryu, MD ^f, Hyun Ah Kim, MD ^f, Yu Mi Jo, MD ^g, Ki Tae Kwon, MD ^h, Hye In Kim, MD ^h, Jang Wook Sohn, MD ⁱ, Young Kyung Yoon, MD ⁱ, Sook In Jung, MD ^j, Kyung-Hwa Park, MD ^j, Hyun Hee Kwon, MD ^k, Mi Suk Lee, MD ^l, Young-Keun Kim, MD ^m, Yeon Sook Kim, MD ⁿ, Jian Hur, MD ^o, Shin-Woo Kim, MD, PhD ^a,^⁎
^a Kyungpook National University Hospital School of Medicine, Daegu, Korea
^b Inje University Busan Paik Hospital, Busan, Korea
^c Korea University Ansan Hospital College of Medicine, Seoul, Korea
^d Eulji University Hospital, Daejeon, Korea
^e Hanyang University Guri Hospital, Guri, Korea
^f Keimyung University Dongsan Medical Center, Daegu, Korea
^g Konyang University College of Medicine, Daejeon, Korea
^h Daegu Fatima Hospital, Daegu, Korea
ⁱ Korea University College of Medicine, Seoul, Korea
^j Chonnam National University Hospital Medical School, Gwangju, Korea
^k Catholic University of Daegu School of Medicine, Daegu, Korea
^l Kyung Hee University School of Medicine, Seoul, Korea
^m Wonju Severance Christian Hospital, Wonju, Korea
ⁿ Chungnam National University School of Medicine, Daejeon, Korea
^o Yeungnam University Medical Center, Daegu, Korea

^∗Address correspondence to Shin-Woo Kim, MD, PhD, Department of Internal Medicine, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu 700-721, Republic of Korea.

Abstract

Background

Postexposure prophylaxis for occupational exposure to hepatitis B virus (HBV) plays an important role in the prevention of HBV infections in health care workers (HCWs). We examined data concerning the acceptable duration between occupational exposure and administration of a hepatitis B immunoglobulin (HBIG) injection in an occupational clinical setting.

Methods

A retrospective analysis was conducted with data from 143 cases of HCWs exposed to HBV in 15 secondary and tertiary teaching hospitals between January 2005 and June 2013. Data were taken from the infection control records of each hospital.

Results

Active vaccination after HBV exposure was started in 119 cases (83.2%) and postvaccination testing for hepatitis B antibody showed positive seroconversion in 93% of cases. In 98 cases (68.5%), HBIG was administered within 24 hours after HBV exposure; however, 45 HCWs (31.5%) received an HBIG injection more than 24 hours postexposure and 2 among the 45 received an injection after 7 days. Although 31.5% received an HBIG injection more than 24 hours postexposure, no cases of seroconversion to hepatitis b antibody positivity occurred.

Conclusions

For susceptible HCWs, HBIG administered between 24 hours and 7 days postexposure may be as effective as administration within 24 hours in preventing occupational HBV infection.

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Highlights

•	The effectiveness of late occupational PEP for HBV after 24 hours was not known.
•	A retrospective analysis was done with data from 143 cases of HCWs in Korea.
•	No case of seroconversion of HBsAg was found even in late HBV PEP group.
•	HBIG administered between 24 hours and 7 days of post-exposure may not be harmful.

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Key Words : Postexposure prophylaxis, Occupational exposure, Hepatitis B virus, Health care workers, Treatment outcomes

Plan

Materials and methods

Setting

Study period and subjects

Statistical analysis

Results

Exposure characteristics

Source patient characteristics

PEP and follow-up HBV serostatus

Discussion

Conclusions

	H-HC, CM, WS C, H-JY, JK, SYR, HAK, YMJ, KTK, HIK, YKY, SIJ, K-HP, HHK, MSL, JH, and S-WK are members of the Antibiotics Stewardship Study Group of the Korean Society for Chemotherapy.
	This work was supported by the Korean Society for Chemotherapy.
	Conflicts of interest: None to report.

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Vol 44 - N° 2

P. 189-193 - février 2016 Retour au numéro

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The acceptable duration between occupational exposure to hepatitis B virus and hepatitis B immunoglobulin injection: Results from a Korean nationwide, multicenter study - 23/01/16

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Background

Methods

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Highlights

Plan

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