Infections with HBV, HCV and HIV in patients admitted to the neurosurgical department of a teaching hospital.

Background And Purpose: To estimate the prevalence of infection with HBV, HCV, HIV and immunization coverage against HBV among neurosurgical patients.

Material And Methods: The study was designed as an anonymous serosurvey conducted at the neurosurgical department of Szczecin University Hospital. Between November and December 2007, blood samples from 100 consecutive patients were tested for anti-HIV, anti-HCV and HBsAg using a third-generation (ELISA) method.

Results: Response rate was 100%. Median age of participants was 51 years, 52% were males. The immunization coverage against HBV was 71% (95% CI: 61.5-79%), 24% (95% CI: 16.7-33.2%) were not immunized, and 5% of patients (95% CI: 2.2-11.2%) did not recall the procedure. There were no differences in immunization rates between emergencies and elective procedures. Four patients (4%; 95% CI: 1.6-9.8%) were positive either with HBV or HCV: 2 were HBsAg positive, 2 anti-HCV positive (2%; 95% CI: 0.6-7%). There were no HIV positive cases among patients.

Conclusions: There is a potential risk to staff of contracting a blood-borne infection, as one in 25 patients was infected with HBV or HCV. Even if patients cover the cost of pre-operative immunization against HBV, with previous HBsAg testing, it would not guarantee the detection of all infected patients, as it refers only to some elective cases. Pre-operative screening for HBV, based on HBsAg testing in immunized patients, detected only 1/4 of patients infected with blood-borne hepatotropic viruses; asymptomatic patients infected with HCV remain a problem in the context of occupationally acquired infections. In the light of the low single exposure risk and lack of serological markers of infection among patients we conclude that employment at a neurosurgical department does not significantly increase the risk of contracting HIV infection.