The risk of hepatitis B virus transmission from infected doctor is greatest when the hepatits B virus carrier doctor is also HBeAg positive.
Transmission from HBeAg negative carriers with high HBV DNA levels can also occur.
Transmission from a needle stick is unlikely when serum HBV DNA is below 10(7) genome equivalents/mL.
Those doctors with serum HBV DNA levels between 5 X10(9) and 6.35 X 10(4) genome equivalents/mL can transmit the disease and should be treated.
Doctors who are HBeAg positive or who have a circulating viral load greater than 10(4) GE/mL (roughly 2,000 IU/mL) should use double gloves for all invasive procedures and should not perform exposure-prone procedures.
Doctor with a higher viral load should undergo antiviral therapy and resume performance of exposure-prone procedures after HBV DNA is suppressed.
(About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr Physician & Cardiologist, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association, Past Academic and Research Wing Head IMA, Chairman Ethics Committee Delhi Medical Council. )
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