[Markers of hepatitis B, C and HIV among orthopedic patients and staff at a Polish university hospital].

Objective: to estimate prevalence of immunization for HBV and seroprevalence for HBV, HCV and HIV among orthopedic patients and staff; to verify the proportion of staff genetically resistant to HIV.

Methods: a voluntary anonymous serosurvey together with immunization history were completed at the orthopedic ward of Szczecin University Hospital (37 beds, 30 doctors and nurses and 1118 admissions annually) between November/December 2006. Blood from 100 consecutive patients and all staff agreeing to participate was tested for anti-HIV, anti-HCV and markers of HBV including anti-HBc total and HBs, as well as for alleles of the CCR5 gene mutated variant with 32-bp deletion.

Results: All off the first 100 patients (median age 51 years, 63% males) and 20 staff (response 67%, median age 35 years, 45% males) agreed to participate. Among patients 64% reported being immunized (95% CI: 54.2-72.7%), 24% (95% CI:16.7-33.2%), not being immunized, 12% (95% CI: 7-19,8%) did not remember. Prevalence of anti-HCV and anti-HIV was 0% (95% CI 0-3.7%); as for HBV, one was HBsAg positive (1%; 95% CI: 0.2-5.4%). Among tested staff none were positive for anti-HCV and anti-HIV. As for HBV, anti-HBc were detected in 8 (40%), 2 had had symptomatic hepatitis, of whom one (5%) was HBsAg positive. No tested staff reported non-occupational risk factors. Seven of eight anti-HBc positive staff had been unaware of previous hepatitis B and underwent full immunisation with three doses of vaccine. Among tested staff 1 (5%) was a homozygote delta32/delta32 allele of the CCR5 receptor, 4 (21%) were heterozygotes +/delta32.

Conclusions: The main study limitation was the small sample size and the fact that one-third of staff refused testing; nevertheless, the carrier state of HBs detected in one percent of tested patients, and high proportion of tested staff with the markers of HBV infection indicates high occupational risk and emphasizes the need for immunization. Nearly all HBc positive staff unaware of their serological status had undergone immunization, showing the importance of pre-immunization testing. In the light of low single exposure risk, lack of serological markers of infection in the current population of orthopedic patients and staff, and 5% of careers of mutated allele of CCR5 detected among staff, we conclude that an employment at orthopedic ward does not significantly increase the risk of contracting HIV infection.