慢性乙型肝炎医护人员的临床和职业健康管理：英国政策和

StephenW

Clinical and occupational health management of healthcare workers living with chronic hepatitis B: UK policy and international comparisons
Grace E Dolman  1 , Apostolos Koffas  2 , Emily Phipps  3 , Patrick T F Kennedy  1
Affiliations
Affiliations

    1
    Barts Liver Centre, Blizard Institute, The London School of Medicine and Dentistry, Queen Mary University of London, Barts, London, UK.
    2
    Department of Gastroenterology, General University Hospital of Larisa, Larisa, Greece.
    3
    Blood Safety, STI and HIV Division, National Infection Service, Public Health England, London, UK.

    PMID: 33665937 DOI: 10.1111/jvh.13494

Abstract

Hepatitis B virus (HBV) is a highly infectious blood-borne virus, which remains endemic in large geographic areas and represents a major global healthcare challenge. HBV transmission from healthcare workers, who perform exposure prone procedures (EPP), to patients is a recognised transmission risk, which varies widely globally. Although the risk is small in developed countries, it increases significantly in high-prevalent, low-resource countries, representing a major challenge to these healthcare systems and underlining the necessity for robust guidance to be in place. The HBV landscape has evolved as a result of global vaccination programs, implementation of standard precautions and the advent of new generation antiviral agents (3rd generation nucleos(t)ide analogues). In light of the progress in the field, the UK Advisory Panel for Healthcare Workers Infected with Blood Borne Viruses (UKAP) recently issued updated guidance, which essentially removes past barriers, restricting healthcare workers from performing EPPs solely on the basis of HBV DNA level, regardless of hepatitis B 'e' antigen and/or treatment status. Although the current recommendations remain conservative compared to those of other developed healthcare systems, UK practice is now in line with other high-income countries, while ensuring patient safety remains paramount, without unduly restricting HCWs from clinical practice. The current article presents the latest UKAP guidance, considers its implications for HCWs and compares it with the guidance from major international scientific societies and governing bodies.

Keywords: Health policy; Public Health; hepatitis B; viral hepatitis.

This article is protected by copyright. All rights reserved.

StephenW

慢性乙型肝炎医护人员的临床和职业健康管理：英国政策和国际比较
格蕾丝·多曼（Grace E Dolman）1，阿波斯托洛斯·科法斯（Apostolos Koffas）2，艾米莉·菲普斯（Emily Phipps）3，帕特里克·肯尼迪（Patrick T F Kennedy）1
隶属关系
隶属关系

    1个
    英国伦敦玛丽皇后大学伦敦医学院和牙科学院Blizard研究所Barts肝脏中心。
    2个
    希腊拉里萨（Larisa），拉里萨（Larisa）通用大学医院消化科。
    3
    英国伦敦英国公共卫生局国家感染服务局血液安全，性传播感染和艾滋病毒部门。

    PMID：33665937 DOI：10.1111 / jvh.13494

抽象的

乙型肝炎病毒（HBV）是一种高度传染性的血液传播病毒，在广大地理区域仍是地方性流行病，是全球医疗保健的主要挑战。从执行易暴露程序（EPP）的医护人员向患者传播HBV是公认的传播风险，在全球范围内差异很大。尽管在发达国家中风险很小，但在高流行，资源匮乏的国家中风险却大大增加，这对这些医疗体系构成了重大挑战，并强调了必须有力的指导意见。由于全球疫苗接种计划，标准预防措施的实施以及新一代抗病毒药物（第三代核苷酸（t）化物类似物）的出现，HBV格局已发生了演变。鉴于该领域的进展，英国感染血源性病毒的医护人员咨询小组（UKAP）最近发布了最新指南，该指南从根本上消除了过去的障碍，限制了医护人员仅根据HBV DNA水平执行EPP，不论乙肝'e'抗原和/或治疗状态如何。尽管与其他发达的医疗体系相比，当前的建议仍然保守，但英国的做法现在与其他高收入国家保持一致，同时确保患者安全仍然是最重要的，而又不会过分限制医护人员的临床实践。本文介绍了UKAP的最新指南，考虑了其对HCW的影响，并将其与主要国际科学学会和理事机构的指南进行了比较。

关键字：卫生政策；公共卫生;乙型肝炎；病毒性肝炎。

本文受版权保护。版权所有。