Original work ACTA.FAC.MED.NAISS. 1998; 15(1), 41-45

POSSIBILITIES AND SIGNIFICANCE OF VIRAL HEPATITIS B PREVENTION
Lj. Drezgić, Z. Veličković, M. Petrović, M. Spasić, G. Tasić

Hepatitis virosis B represents a complex health care problem, in view of its high incidence and concommitant subsequent complications. Reservoir of viruses are the chronic carriers, according to estimations, approximately 300 milions throughout the ţvorld. (Maynard J.E. et al.,1988). Most significant complications are liver cirosis and hepatocelular carcionoma.
The incidence of hepatitis B worldwide is very different, and is estimated according to the height of seroprevalence of HBV marker in the population. In high endemic regions 95% of the population is infected, and 8-15% are carriers; in the median endemic regions seroprevalence is 20-25%, and 2-7% are carriers (East and South Europe, ex-Soviet Union, South America, Near East), while low endemic regions are North Europe, North America, Australia, with 0,2-0,9% of chronic carriers in the population.
The data about the seroprevalence of our population and number of carriers are scarce, and it is estimated that the percent of carriers is 1-5%, depending on the region.
In our work we present the results of HBV seroprevalence investigation, in the part of the population exposed to higher infection risk, performed vaccination and first results.
The examined population included health care workers, as well as the patients of institutions for mentally deprived and those on haemodialysis. Out of the total number (1517) -30,8% were HBV seroprevalence, but there are significant differences between medical staff (21,3%) and patients (73,3%). Apparent are the differences in the percent of identified carriers: 2,0% of investigated medical workers, and 17,3% of examined patients. Depending on the place of work, exposure, the percent of seroprevalence ranges from 37,2% (transfusion) to 16,6% (pathology) or 25,6% (surgeons) to 5,3% (general practitioners). These percents represent the result of natural seroprevalence, before vaccination. One of the safest prophylactic measures against HBV infection is vaccination, performed with a vaccine obtained by genetic engineering. After the performed examinations, vaccination was performed on 1996 persons. The efficacy of this procedure was controled following morbidity in vaccinated population. In the period of 6 years,1 person was affected (after the accident at work with HBsAg positive blood, 3 years after vaccination).
Vaccine against HBV infection is indirectly a prophylactic measure against hepatitis D and hepatocellular carcinoma and certainly should be made use of.

Key words: Hepatitis B, Seroprevalence, Vakcination