Health-care workers positive for hepatitis B surface antigen. Are their contacts at risk?

To assess the hepatitis risk to patients exposed to HBs AG-positive health-care workers, 228 contacts were followed prospectively for six to nine months. Health workers included two physicians with chronic hepatitis, a chronic asymptomatic carrier nurse, a food handler with acute HBs Ag-positive hepatitis and a physician who was HBs Ag-positive for 25 days before the onset of acute hepatitis. Controls (167) consisted of identically followed patients who had not been exposed to an HBs Ag-positive health worker. No exposed or control patient acquired clinical hepatitis or HBs Ag. Isolated elevations in serum glutamic pyruvic transaminase occurred equally in both groups and did not correlate with serologic evidence for hepatitis B infection. One exposed patient demonstrated antibody seroconversion (anti-HBs), as did two of the controls. These data do not demonstrate hepatitis B transmission from HBs Ag-positive health workers to their patients. Restriction of such carriers is not warranted at present.