Hepatitis B and the surgeon

Hepatitis B virus is the most transmissible virus and is very resistant to heat and chemicals, because of its unique structure. Blood has the maximum concentration of the virus among all the body fluids and the risk of transmission is related to the presence of HBeAg and the Hepatitis B virus DNA level in the blood. In India, about 1-10% of the healthcare workers are HBsAg positive. Healthcare workers, especially surgeons, and laboratory technicians are at a high risk of developing Hepatitis B infection. Transmission from Hepatitis B positive surgeons to patients has been well-documented. However, the risk of transmission from a patient to a surgeon is higher - about 30% - following a needle stick injury from an HBeAg positive individual. In India, there is low awareness among healthcare personnel about Hepatitis B vaccination and its related issues, and there is no health policy in this regard. In relation to the healthcare workers, there is an urgent need to formulate guidelines on HBsAg testing, hepatitis B vaccination, restriction of exposure-prone procedures that have to be performed, the extent to which their serological status can be revealed to patients, implementation of universal precautions, and post-exposure prophylaxis.