SEROSURVEY OF HUMAN-IMMUNODEFICIENCY-VIRUS, HEPATITIS-B VIRUS, AND HEPATITIS-C VIRUS-INFECTION AMONG HOSPITAL-BASED SURGEONS

BACKGROUND: Because occupational blood contact places health-care work ers at risk for infection with bloodborne pathogens, we wanted to esti mate the prevalence of infection with human immunodeficiency virus (HI V), hepatitis B virus (HBV), and hepatitis C virus (HCV) among hospita l-based surgeons and correlate the results with occupational and nonoc cupational risk factors, STUDY DESIGN: All surgeons in training or in practice in general surgery, obstetrics and gynecology, or orthopedics at 21 hospitals in moderate to high AIDS incidence areas were eligibl e to participate in a voluntary, anonymous serosurvey, Serum samples w ere tested for HIV antibody, for II(SV antibody, and for markers of HB V infection: hepatitis B surface antigen, total antibody to hepatitis B core antigen, and antibody to hepatitis B surface antigen, RESULTS: Of 2,887 eligible surgeons, 770 (27 percent) participated in the study , One of 740 surgeons not reporting nonoccupational risk factors was H IV seropositive (0.14 percent, upper limit 95 percent confidence inter val [CI] equals 0.64 percent), None of 20 participants reporting nonoc cupational HIV risk factors and none of ten not responding to the ques tion on nonoccupational risk factors were HIV positive. Of 129 (17 per cent) participants with past or current HBV infection, three (0.4 perc ent) had chronic HBV infection; all were negative for hepatitis B e an tigen, Risk factors for HBV infection included not receiving hepatitis B vaccine (odds ratio [OR] 14.7, 95 percent CI 8.3 to 26.0) and pract icing surgery at least ten years (OR 2.2, 95 percent CI 1.3 to 3.8), S even (0.9 percent) participants had anti-HCV. CONCLUSIONS: Although no t necessarily generalizable to all surgeons in moderate to high AIDS i ncidence areas, these results do not indicate a high rate of previousl y undetected HN infection among surgeons who trained or practiced in t hese areas, or both, Hepatitis B virus posed the highest risk of infec tion with a bloodborne pathogen, followed by HCV and HIV.