Highly viremic health care workers are often advised to restrict performing exposure prone procedures.
This is to prevent transmission of Hepatitis B virus from health care workers to patients.
Dr Janssen and colleagues from the Netherlands offered highly viremic health care workers antiviral therapy.
The therapy was offered to prevent loss of highly qualified medical personnel, and simultaneously minimize transmission risk to patients.
The research team then evaluated the effects of this strategy.
The team monitored 18 Hepatitis B-infected health care workers every 3 to 6 months for a median period of 6 years.
|Antiviral therapy persistently suppresses virus levels below 105 copies/mL |
|Journal of Viral Hepatitis|
Antiviral therapy was offered if Hepatitis B viral DNA was above 105 copies/mL.
The researchers also offered antiviral therapy if exposure prone procedures were performed or active liver disease was present.
Median Hepatitis B virus DNA levels during antiviral therapy were analyzed.
The team also measured the percentage of days with Hepatitis B virus DNA above 103, 104 and 105 copies/mL.
Reduction of Hepatitis B virus DNA during antiviral treatment was measured.
The team evaluated these outcomes in Hepatitis B e antigen-positive and Hepatitis B e antigen-negative health care workers separately.
The researchers achieved prolonged viral suppression in both Hepatitis B e antigen-positive, as well as Hepatitis B e antigen-negative health care workers.
In Hepatitis B e antigen-negative health care workers, treatment with interferon or lamivudine maintained virus DNA levels below 105 copies/mL.
For Hepatitis B e antigen-positive health care workers continuous treatment with tenofovir or entecavir was essential for reaching low viremia persistently.
In 2004, the team observed that median Hepatitis B virus DNA levels in both Hepatitis B e antigen-negative and -positive workers were below 103 copies/mL.
The researchers noted that all health care workers executed their professional work full-range.
Dr Janssen's team concludes, “For both Hepatitis B e antigen-positive and Hepatitis B e antigen-negative health care workers, antiviral treatment is effective in persistent suppression of virus levels below 105 copies/mL.”
“This observation supports antiviral therapy as a viable management option instead of work restriction.”
“Regular expert monitoring including quantification of Hepatitis B virus DNA has to be provided.”