Health-Care Workers Positive for Hepatitis B Surface Antigen: Are Their Contacts at Risk?

To assess the hepatitis risk to patients exposed to HB_sAg-positive health-care workers, 228 contacts were followed prospectively for six to nine months. Health workers included two physicians with chronic hepatitis, a chronic asymptomatic carrier nurse, a food handler with acute HB_sAg-positive hepatitis and a physician who was HB_sAg-positive for 25 days before the onset of acute hepatitis. Controls (167) consisted of identically followed patients who had not been exposed to an HB_sAg-positive health worker. No exposed or control patient acquired clinical hepatitis or HB_sAg. Isolated elevations in serum glutamic pyruvic transaminase occurred equally in both groups and did not correlate with serologic evidence for hepatitis B infection. One exposed patient demonstrated antibody seroconversion (anti-HB_s), as did two of the controls. These data do not demonstrate hepatitis B transmission from HB_sAg-positive health workers to their patients. Restriction of such carriers is not warranted at present. (N Engl J Med 292:454–457, 1975). THE risk that health-care personnel positive for hepatitis B surface antigen (HB_sAg) represent to their patients is currently undefined, and the implications of removing such trained personnel from patient contact are great. Although such personnel may represent an undue infectious risk to their professional contacts, few published reports^{1 2}deal with this possibility, and in each case these reports represent retrospective investigations. A controlled prospective follow-up study of the patient contacts of two physicians and a nurse who were persistent carriers of HB_sAg and of a physician and a food handler who worked during the prodrome of.