Effect of vaccination on the risk of hepatitis B infection in hospital personnel

The effect of vaccination on acute B hepatitis, on HBsAg carrier state and on the seropositivity of hepatitis B virus was examined in the personnel of the St. Laszlo Hospital in two periods. Human plasma origin vaccine was introduced gradually from 1985 to 1989. From 1989 till the end of 1994 recombinant vaccines were provided for all workers. A total of 10577 tests were done from 3524 sera of 2019 hospital workers. A total of 2.4% of the workers developed acute hepatitis. Hepatitis B was confirmed most frequently (29%) of hepatitis cases. In the first and second period HBsAg positivity was 4.1% and 2.1% (P = 0.1), respectively. Although the annual frequency of acute hepatitis has not changed, that of HBsAg positivity showed a decreasing tendency during the nine years of the study. The prevalence of hepatitis B markers could be characterized by a significant rise in close correlation with age. The protective effect of vaccination is markedly reflected by the altered prevalence of hepatitis B virus markers in the different age groups. At the age of fifty and above hepatitis B seropositivity was 47.2% and 36.4% in the first and second period (P = 0.1), respectively. The frequency of seropositivity was the highest among the workers of surgical, pathological, hepatological departments and ICU. Our results show that vaccination is an effective tool in hepatitis B prevention. Every effort has to be made to promote hepatitis B immunity to all health care workers and strictly follow hygienic preventive measures.