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Prevalence of Hcv & Hbv Among Medical Residents Innew Damietta Hospital (Al-Azhar University Hospital)

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Prevalence of Hcv & Hbv Among Medical Residents Innew Damietta Hospital (Al-Azhar University Hospital) AAMJ, Vol. 11, N. 2, April, 2013 ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ PREVALENCE OF HCV & HBV AMONG MEDICAL RESIDENTS INNEW DAMIETTA HOSPITAL (AL-AZHAR UNIVERSITY HOSPITAL) Mohamed Amer Afify1*, Mohamed Negm2*, Mekky Abd-Elmonem1***, Ahmed Ali1**, Khaled El Mola1*** and Fareid Fareid Attia1*** Tropical medicine1 and Clinical pathology2 departments - Faculty of Medicine - Al-azhar University (Cairo)*, Alfayom University,Al-azhar University (Damietta)*** ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ABSTRACT Background: Hepatitis C Virus (HCV) and hepatitis B Virus (HBV) are the most common causes of chronic liver with serious complications. Both viruses are spread mainly through blood transfusion, contaminated blood products and contaminated needles. Health care workers are of high risk for exposure (Fattovich et al., 2011). Objective: The aim of this study is to evaluate prevalence of HCV & HBV among medical residents in New Damietta Hospital Al-Azhar University Hospital to promote the preventive measures of transmission of viral hepatitis. Methods: This study was carried out among medical residents in New Damietta University hospital who are working in different departments between the period from January 2012 to January 2013 in New Damietta University hospital. One hundred medical residents in New Damietta University hospital were planned to participate in our study but 10 of them refusing the participation, only 90 residents (physicians and surgeons) were subjected to provide a written consent for enrollment . Results: Our results showed that prevalence of HBs Ag, HBc Ab, HBs Ab and HCV Ab was 0 %, 45.5%, 22.2% and 0% respectively among residents in New Damietta Hospital (Al-Azhar University). Conclusion: HBV and HCV viral infections are 307 Mohamed Amer Afify et al ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ a well-recognized occupational risk for Health care workers. Health care workers in recipient and surgical departments are more exposed to anti-HBc infection among medical residents in New Damietta hospital AlAzhar University hospital. Key words HBV, HCV, Medical residents and New Damietta hospital. INTRODUCTION Chronic viral hepatitis is the most common cause of chronic liver disease. Hepatitis C Virus (HCV) and hepatitis B Virus (HBV) are the most common causes with serious complications. Both viruses are spread mainly through blood transfusion, contaminated blood products and contaminated needles. Health care workers are of high risk for exposure (Fattovich et al., 2011). One of the problems in recognizing this epidemic is that it is a "silent” epidemic. That is to say, most people who are infected do not know they are infected and have not reached the stage of the disease when clinical symptoms of liver failure begin to show (Wilkins et al., 2010). Occupational blood-borne infections are associated with significant morbidity and mortality. Health care workers (HCWs) are exposed to hazardous blood-borne pathogens such as hepatitis B virus (HBV) and hepatitis C virus (HCV). HBV and HCV infections are serious public health problems that have consequences in terms of psychological and occupational diseases. HBV and HCV are common causes of occupational diseases transmitted from patients to HCWs and vice versa and also to HCWs' families. Fortunately, most occupational transmissions can be prevented by standard precautions (Bosques et al., 2010). Post-exposure prophylaxis should be considered. Hepatitis B vaccine has been available since 1981. It is 95% effective in preventing infection and its AAMJ, Vol. 11, N. 2, April, 2013 ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ chronic consequences. It is the first vaccine against a major human cancer. Immunity is predicted to last at least 25 years (Cornberg et al., 2011). No prophylactic or therapeutic vaccine against hepatitis C is available. The earlier the introduction of interferon, the higher the rate of resolved infection (Pockros et al., 2010). SUBJECTS AND METHODS Our study was a cross-sectional study carried out among medical residents in New Damietta University hospital (Al-Azhar University) who are working in different departments. One hundred medical residents in New Damietta University hospital were planned to participate in our study but 10 of them refusing the participation, only 90 residents (physicians and surgeons) were subjected to provide a written consent for enrollment. The study was carried out from January 2012 to January 2013. The residents were divided into three groups according to the period of their residence:- -Group I: Include 17 doctors who have been worked as a residence for one year. -Group II: Include 44 doctors who have been worked as a residence for two years. -Group III: Include 29 doctors who have been worked as a residence for three years. Methodology After taking an informed consent from each individual accept to participate in the study; all participants were subjected to, full personal history taking, past 309 Mohamed Amer Afify et al ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ history of HCV infection, HBV infection, HBV vaccination, blood transfusion, surgical operation, dental procedures, acupuncture, schistsomiasis, sharp exposure (needle stick and sharp injuries) during interventions (surgical operations, GIT endoscopic unit, hemodialysis unit.., etc.,), splashes to eye and sharing personal items such as toothbrushes and razors, family history to HCV infection and or HBV infection, complete clinical examination as jaundice and hepatosplenomegaly and laboratory investigations, CBC, SGPT, SGOT, GGT, s.bilirubin, s.albumin, prothrombin time, INR, blood urea, s.creatinine, hepatitis B viral markers including hepatitis B surface antigen (HBs Ag), hepatitis B core antibody (HBc Ab) and hepatitis B surface antibody (HBs Ab) by ELISA technique,Hepatitis C virus antibody (HCV Ab) by ELISA technique.It was done by COBAS CORE auto analyzer; the kits were supplied by (Roche, USA). AAMJ, Vol. 11, N. 2, April, 2013 ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ RESULTS Table (1) Basic data of the participants I (n=17) II (n=44) III (n=29) Total t No % No % No % (Non=9 0)% P value test Age (mean ± SD) 25± 2 27± 2 29± 2 -- 0.68 0.65(NS) Married 6 35.3 26 59.1 26 89.7 --58 64.4 Marital 14.89 0.001* status Not 11 64.7 18 40.9 3 10.3 32 35.6 Rural 7 41.2 20 45.5 8 27.6 35 38.9 0.30(Ns) Residence Urban 10 58.8 24 54.5 21 72.4 55 61.1 2.39 Past history HBV Positive 2 11.8 8 18.2 5 20.8 15 16.7 0.37 Vaccination Negative 15 88.2 36 81.8 24 79.2 75 83.3 blood Positive 0 0 0 0 0 0 0 0 a transfusion Negative 17 100 44 100 29 100 90 100 surgical Positive 0 0 2 4.5 0 0 2 2.2 2.13 34(NS) operations Negative 17 100 42 95.4 29 100 88 97.8 Positive 0 0 0 0 0 0 0 0 schistsomiasis a Negative 17 100 44 100 29 100 90 100 dental Positive 6 35.3 21 47.7 12 41.4 39 43.3 0.83 0.65(NS) procedures Negative 11 64.7 23 52.3 17 58.6 51 56.7 Positive 0 0 0 0 1 3.4 1 1.1 acupuncture 2.12 0.34(NS) Negative 17 100 44 100 28 96.6 89 98.9 splashes to Positive 0 0 6 13.6 1 3.4 7 7.8 4.29 0.11(NS) eye Negative 17 100 38 86.4 28 96.6 83 92.2 Sharing Positive 4 23.5 9 20.5 7 24.1 20 22.2 personal 0.92(NS) 0.15 items Negative 13 76.5 35 79.5 22 75.9 70 77.8 Sharp Positive 3 17.6 18 41 9 31 30 33.3 0.21(NS) exposure Negative 14 82.4 26 59 20 69 60 66.7 3.08 other Positive 0 0 1 2.3 2 6.9 3 3.3 0.39(NS) diseases Negative 17 100 43 97.7 27 93.1 87 96.7 1.88 Table (2) Prevalence of viral markers among residents in New Damietta Hospital Total participants (n=90) + ve - ve Subjects No % No % HBs Ag 0 0 90 100 HBc Ab 41 45.5 49 54.5 Viral markers HBs Ab 20 22.2 70 77.8 HCV Ab 0 0 90 100 311 Mohamed Amer Afify et al ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ Table (3) Prevalence of HBc Ab among studied groups I II III Total Total (n=17) (n=44) (n=29) (n=90) P detected X2 No % No % No % No % % value Negative 8 47.1 24 54.5 17 58.6 49 54.5 - Positive 9 52.9 20 45.5 12 41.4 41 45.5 100 +ve with – 0.74 veHBsAb and-ve 6 66.7 12 60 10 83.3 28 31.1 68.3 0.57 (NS) HBsAg +ve with detected HBsAb 3 33.3 8 40 2 16.7 13 14.4 31.7 +ve with HBsAb titre >10 3 100 5 62.5 0 0 8 8.9 61.5 IU/ml 0.038* 5.07 +ve with HBsAb titre <10 0 0 3 37.5 2 100 5 5.6 38.5 IU/ml Table (4) HBc Ab in relation to personal data among studied groups HBc Ab in studied participants (n= 90) X2 P value Studied variables + ve - ve No % No % < 27 years 9 22 8 16.3 27 – 29 years 20 48.8 24 49 0.57 0.74(NS) Age groups > 29 years 12 29.2 17 34.7 Married 30 73.2 33 67.3 0.36 0.54(NS) Marital status Not married 11 26.8 16 32.7 Rural 15 36.6 20 40.8 0.16 0.68(NS) Residence Urban 26 63.4 29 59.2 Elgharbia 8 19.5 7 14.3 Elsharkia 3 7.3 2 4.1 Eldakahlia 14 34.2 13 26.5 Elmenofiya 3 7.3 5 10.2 Damietta 5 12.3 10 20.4 0.92(NS) Kafr-Elshikh 3 7.3 6 12.2 4.46 Elgiza 1 2.4 1 2 Cairo 1 2.4 2 4.1 Residence according Elkalyobia 1 2.4 1 2 to governorates Elbehira 2 4.9 1 2 Alfayom 0 0 1 2 AAMJ, Vol.
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