Significant Proportion of Acute Hepatitis B in Poland in 2010-2014 Attributed to Hospital Transmission: Combining Surveillance and Public Registries Data

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2018 Apr 11

PMID 29631545

Citations 3

Authors

Malgorzata Stepien

Karolina Zakrzewska

Magdalena Rosinska

Affiliations

Soon will be listed here.

Abstract

Background: Efficient control of acute hepatitis B requires identification of current transmission routes. Countries in Central-Eastern Europe including Poland attribute an important fraction of cases to nosocomial transmission, as opposed to Western European countries. However, due to possible multiple exposures during the incubation time such assignment may be debatable. This study aimed at assessing of most affected groups and current transmission pattern of acute hepatitis B.

Methods: We investigated exposures reported by acute hepatitis B cases notified to routine surveillance system in Poland in 2010-2014 in comparison to data on hospitalization rates in general population.

Results: Hospitalization during incubation time significantly increased the risk of HBV infection (RR 3.13, 95%CI 2.58-3.80). Overall hospitalization population attributable risk (PAR%) was 25.7% (95% CI 20.3%-31.1%) as compared to 35% of acute cases assigned to hospital transmission in surveillance database. PAR% increased from 9.5% (1.12%-17.8%) in the age group 25-34 to 41.1% (28.2% - 53.9%) among those 65 +. In addition, cases < 40 more frequently than the older ones reported history of injecting drugs and risky sexual contacts (25% vs 5%). 27% of men < 40 did not report any exposure at all, drawing attention to possible underreporting of risk behaviors.

Conclusions: The distribution of probable transmission routes differed by age and gender. Further improvement of HBV control requires better coverage of vaccination in risk groups but also strengthening the blood-borne infections control in hospitals.

Citing Articles

Knowledge, awareness, and vaccination compliance of hepatitis B among medical students in Riyadh's governmental universities.

Altamimi A, Alqahtani T, Ahmed J, Aldosari L, Alzahrani M, Alotaibi G J Family Med Prim Care. 2021; 10(1):485-490.

PMID: 34017775 PMC: 8132782. DOI: 10.4103/jfmpc.jfmpc_1419_20.

Hepatitis B and C among healthcare workers and patient groups at increased risk of iatrogenic transmission in the European Union/European Economic Area.

Tavoschi L, Mason L, Petriti U, Bunge E, Veldhuijzen I, Duffell E J Hosp Infect. 2019; 102(4):359-368.

PMID: 30885816 PMC: 6667732. DOI: 10.1016/j.jhin.2019.03.004.

Seroprevalence of anti-HBc, risk factors of occupationally acquired HBV infection and HBV vaccination among hospital staff in Poland: a multicenter study.

Ganczak M, Topczewska K, Budnik-Szymoniuk M, Korzen M BMC Public Health. 2019; 19(1):298.

PMID: 30866893 PMC: 6417128. DOI: 10.1186/s12889-019-6628-1.

References

. Investigation of viral hepatitis infections possibly associated with health-care delivery--New York City, 2008-2011. MMWR Morb Mortal Wkly Rep. 2012; 61(19):333-8. View

Duffell E, Milne L, Seng C, Young Y, Xavier S, King S . Five hepatitis B outbreaks in care homes in the UK associated with deficiencies in infection control practice in blood glucose monitoring. Epidemiol Infect. 2010; 139(3):327-35. DOI: 10.1017/S0950268810001007. View

Goldstein S, Alter M, Williams I, Moyer L, Judson F, Mottram K . Incidence and risk factors for acute hepatitis B in the United States, 1982-1998: implications for vaccination programs. J Infect Dis. 2002; 185(6):713-9. DOI: 10.1086/339192. View

Duffell E, Hedrich D, Mardh O, Mozalevskis A . Towards elimination of hepatitis B and C in European Union and European Economic Area countries: monitoring the World Health Organization's global health sector strategy core indicators and scaling up key interventions. Euro Surveill. 2017; 22(9). PMC: 5356432. DOI: 10.2807/1560-7917.ES.2017.22.9.30476. View

Stepien M, Rosinska M . Hepatitis C oubreaks in Poland in 2003-2013. Medical procedures as a dominant route of HCV transmission. Przegl Epidemiol. 2015; 69(3):465-72, 585-90. View

Hartleb M, Gutkowski K, Zejda J, Chudek J, Wiecek A . Serological prevalence of hepatitis B virus and hepatitis C virus infection in the elderly population: Polish nationwide survey--PolSenior. Eur J Gastroenterol Hepatol. 2012; 24(11):1288-95. DOI: 10.1097/MEG.0b013e328357632a. View

Magdzik W, Czarkowski M . [Epidemiological situation of hepatitis B in Poland in the years 1979-2004]. Przegl Epidemiol. 2007; 60(3):471-80. View

Rockhill B, Newman B, WEINBERG C . Use and misuse of population attributable fractions. Am J Public Health. 1998; 88(1):15-9. PMC: 1508384. DOI: 10.2105/ajph.88.1.15. View

Grabarczyk P, Kopacz A, Sulkowska E, Kubicka-Russel D, Mikulska M, Brojer E . Blood donors screening for blood born viruses in Poland. Przegl Epidemiol. 2015; 69(3):473-7, 591-5. View

10.

Pourkarim M, Verbeeck J, Rahman M, Amini-Bavil-Olyaee S, Forier A, Lemey P . Phylogenetic analysis of hepatitis B virus full-length genomes reveals evidence for a large nosocomial outbreak in Belgium. J Clin Virol. 2009; 46(1):61-8. DOI: 10.1016/j.jcv.2009.06.015. View

11.

Ganczak M, Dmytrzyk-Danilow G, Korzen M, Szych Z . A cross-sectional serosurvey on hepatitis B vaccination uptake among adult patients from GP practices in a region of South-West Poland. BMC Public Health. 2015; 15:1060. PMC: 4609044. DOI: 10.1186/s12889-015-2388-8. View

12.

Fabrizi F, Dixit V, Messa P, Martin P . Transmission of hepatitis B virus in dialysis units: a systematic review of reports on outbreaks. Int J Artif Organs. 2015; 38(1):1-7. DOI: 10.5301/ijao.5000376. View

13.

Magdzik W . Hepatitis B epidemiology in Poland, Central and Eastern Europe and the newly independent states. Vaccine. 2000; 18 Suppl 1:S13-6. DOI: 10.1016/s0264-410x(99)00454-5. View

14.

Magdzik W, Czarkowski M . [Coverage of vaccination against hepatitis B in Poland in 2004]. Przegl Epidemiol. 2006; 60(2):185-92. View

15.

Lanini S, Puro V, Lauria F, Fusco F, Nisii C, Ippolito G . Patient to patient transmission of hepatitis B virus: a systematic review of reports on outbreaks between 1992 and 2007. BMC Med. 2009; 7:15. PMC: 2676313. DOI: 10.1186/1741-7015-7-15. View

16.

Lanini S, Garbuglia A, Puro V, Solmone M, Martini L, Arcese W . Hospital cluster of HBV infection: molecular evidence of patient-to-patient transmission through lancing device. PLoS One. 2012; 7(3):e33122. PMC: 3295785. DOI: 10.1371/journal.pone.0033122. View

17.

Allain J, Candotti D . Hepatitis B virus in transfusion medicine: still a problem?. Biologicals. 2012; 40(3):180-6. DOI: 10.1016/j.biologicals.2011.09.014. View

18.

Ganczak M, Ostrowski M, Szych Z, Korzen M . A complete HBV vaccination coverage among Polish surgical nurses in the light of anti-HBc prevalence: A cross-sectional sero-prevalence study. Vaccine. 2010; 28(23):3972-6. DOI: 10.1016/j.vaccine.2010.03.042. View

19.

Czerwinski M, Grabarczyk P, Stepien M, Kubicka-Russel D, Tkaczuk K, Brojer E . What weighs more-low compliance with self-deferral or minor medical procedures? Explaining the high rate of hepatitis C virus window-period donations in Poland. Transfusion. 2017; 57(8):1998-2006. PMC: 5703057. DOI: 10.1111/trf.14163. View

20.

Kolosova A, Gasparovic J . Viral hepatitis B and C outbreak related to parenteral treatment at an oncological department in Slovakia. J Hosp Infect. 2016; 93(2):211-4. DOI: 10.1016/j.jhin.2016.01.013. View