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438 Hepatitis B virus Vaccination as a Pre-Exposure Prophylaxis v.s. Hepatitis B Immunoglobulin Post-Exposure among Healthcare Personnel after Needle stick Injury

Sunday, April 3, 2011
Trinity Ballroom (Hilton Anatole)
Romanee Chaiwarith, MD, MHS , Division of Infectious Diseases, Faculty of Medicine, Chiang Mai University, Muang, Thailand
Saowaluck Foopingwong, BSc , Infection Control Unit, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
Peninnah Oberdorfer, MD, PhD , Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chiang Mai, Thailand
Background: Hepatitis B virus vaccination protect against HBV infection in 99% of vaccinated people. However, HBV vaccination is not mandatory for healthcare personnel (HCP) in our hospital. After needlestick injury from HBs antigen positive source, unvaccinated HCP will receive hepatitis B immunoglobulin (HBIG) and HBV vaccine or HBV vaccine if the source has HBs antigen negative

Objective:

This study aims to compare the expense associated with HBV vaccine before needlestick injury and HBIG/HBV vaccine after needlestick injury among healthcare personnel

Methods:

A retrospective data collection on occupational exposure to bloodborne pathogen among healthcare personnel was reviewed between January 1, 2005 and December 31, 2009. The cost expenses for HBV vaccine among HCP before the injury were compared with the cost expenses for HBIG after the injury.

Results:

Over the 5-year period, there were 1523 healthcare personnel had occupational exposure to bloodborne-pathogen. Nine hundreds and forty-three events were needle stick injury. Of these, 135 sources had positive HBs antigen and 34 sources had unknown HBs antigen status. One hundred and six healthcare personnel had positive anti-HBs antibody and these healthcare personnel did not receive HBIG and HBV vaccine. Sixty-three healthcare personnel who had neither HBV vaccination nor hepatitis B virus infection did received HBIG or HBV vaccine or both. During 5 year-periods, there were 3586 new healthcare personnel. The expense for HBV vaccine if it had been provided to all healthcare personnel was 140000 USD. The expense for HBIG/HBV vaccine or both among healthcare personnel after needlestick injury was 5500 USD.

Conclusions: Although HBV vaccination is recommended for healthcare personnel, it was not followed as hospital-wide program due to limited budget. HBIG after needlestick injury instead of HBV vaccination among healthcare personnel may be reasonable for hospital-wide program in resource-limited setting