‘Safe’ clinical practices unwittingly spur hepatitis B virus

April 13th, 2009 - 4:31 pm ICT by IANS  

London, April 13 (IANS) Routine clinical practices, presumed safe, could spur patient-to-patient transmission of hepatitis B virus (HBV), one of the most lethal of its kind.
A review of 33 HBV outbreaks has shown that the most frequent HBV transmission routes are administration of drugs using multi-vial compounds and capillary blood sampling (e.g. for glucose monitoring) using non-disposable devices.

Simone Lanini led researchers from the Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Rome, who performed a systematic review of HBV outbreaks published between 1992 and 2007 within the European Union and the US.

Lanini said HBV remains an important cause of liver disease in developed countries. Moreover, the virus has long been recognised as one of the most insidious viral agents within health care settings.

The authors included 30 papers in their review, featuring information on 33 HBV outbreaks, involving 471 patients and 16 fatal cases.

Sixteen out of the 33 outbreaks were from EU countries; the remaining 17 outbreaks were from the US. There were no significant differences in the main epidemiological parameters between the two areas.

An epidemiological study is a statistical study on human populations, which attempts to link human health effects to a specified cause

The majority of the outbreaks originated among patients already affected by one or more underlying conditions causing some degree of immuno-depression.

“Firstly, we found that dialysis units accounted for the highest number of outbreaks (10 out of 33)” said Lanini, according to an Istituto Nazionale release.

The authors conclude: “We have found that several breaches in infection control measures, related to some routine clinical practices thought to be risk-free (e.g. point of care blood glucose monitoring or preparation and administration of common parenteral drugs with multi-vial compounds) could result in patient-to-patient transmission of HBV.”

These findings were published in the open access journal BMC Medicine.

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