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Report of a WHO Consultation on the Prevention of Human Immunodeficiency Virus and Hepatitis B Virus Transmission in the Health Care Setting, Geneva, 11-12 April 1991.
[Unpublished] 1991. , 8 p. (WHO/GPA/DIR/91.5)The transmission of both Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) in health care settings causes concern among patients, health care workers, and national policymakers. This document reports recommendations from a consultative meeting on the issue organized by the World Health Organization Global Program on AIDS. The meeting was held at the request of member states to review risks of transmission of HBV and HIV in the health care setting, and to provide guidance on policies and strategies to minimize such risks. In order of declining incidence and likelihood, HBV and HIV may be transmitted from patient to patient, patient to worker, and worker to patient. The risk of infection depends on the prevalence of infected individuals in the population, the frequency of exposure to contaminated medical instruments, relative viral infectivity, and the concentration of virus in the blood. The risk of acquiring HBV from a needlestick exposure to blood of an infected patient is estimated at 7-30%, while less than 0.5% of health care workers exposed in similar fashion to HIV+ blood have become infected with HIV. General recommendations and specific measures for WHO and national authorities to adopt in the prevention of these infections are listed. Central to prevention is the adoption by health care workers of universal precautions which assume that all blood and certain bodily fluids are infectious. HBV vaccines for both health care workers and as a routine infant immunogen are recommended where appropriate. Routine and/or mandatory blood testing of workers or patients is not recommended, and is considered potentially counterproductive to AIDS control.