The hidden burden of viral hepatitis B and C in healthcare settings: a cross-sectional study of seroprevalence, predictors, and occult infection
8 affiliations
- 1Department of Epidemiology and Modern Vaccination Technologies, Institute of Professional Education, I. M. Sechenov First Moscow State Medical University (Sechenov University)
- 2Laboratory of Vaccine Prevention and Immunotherapy of Allergic Diseases, Federal State Budgetary Scientific Institution “I. Mechnikov Research Institute of Vaccines and Sera”
- 3Laboratory of Molecular Epidemiology of Viral Hepatitis, Central Research Institute of Epidemiology
- 4Laboratory of Viral Hepatitis, Federal State Budgetary Scientific Institution “I. Mechnikov Research Institute of Vaccines and Sera”
- 5Department of Propaedeutics of Children’s Diseases, N. F. Filatov Clinical Institute of Children’s Health, I. M. Sechenov First Moscow State Medical University (Sechenov University)
- 6Department of Internal, Occupational Diseases, and Rheumatology, N. V. Sklifosovsky Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University (Sechenov University)
- 7Department of Social Hygiene, Organization of Surveillance, with a Course of Laboratory Diagnostics, Dagestan State Medical University
- 8Department of Epidemiology and Evidence-Based Medicine, F. F. Erisman Institute of Public Health, I. M. Sechenov First Moscow State Medical University (Sechenov University)
Abstract
Background: Bloodborne viral hepatitis B and C remain critical occupational hazards for healthcare workers (HCWs). Current mandatory screening in some countries, including Russia, relies solely on hepatitis B surface antigen (HBsAg) detection, which may overlook occult infections. This study aimed to evaluate the prevalence, predictors, and occupational risks of HBV (including occult HBV infection) and HCV among HCWs in multidisciplinary facilities.
Methods: A cross-sectional observational study of 1,643 HCWs and auxiliary staff was conducted. Blood serum samples were tested for anti-HBc, anti-HBs, and anti-HCV antibodies using ELISA. Seropositive individuals underwent real-time PCR testing to detect HBV DNA and HCV RNA. Multivariable logistic regression was used to identify independent predictors of seropositivity.
Results: Anti-HBc IgG was detected in 36.6% of HCWs, demonstrating a strong age gradient (aOR = 1.55 per 10 years of age; p < 0.001), rising from 12.4% in those under 30 to 50% in those over 60. Anti-HBs levels ≥10 mIU/mL were observed in only 54.8% of HCWs, dropping to 29.7% at a stricter threshold (>100 mIU/mL). High anti-HBs titers (100–1,000 mIU/mL) were strongly associated with anti-HBc positivity (aOR = 4.65; p < 0.001). Occult hepatitis B infection (OBI) was detected in 3.1% (95% CI 0.85–7.73%) of tested anti-HBc-positive HCWs, who exhibited lower median anti-HBs concentrations compared to PCR-negative counterparts (7 vs. 165 mIU/mL; p = 0.003). HBV DNA was detected in 4 of 129 HBsAg-negative, anti-HBc-positive participants (3.1%), a finding consistent with possible occult HBV infection. Notably, 75% of OBI cases were classified as low occupational risk. Anti-HCV prevalence was 5%, but HCV RNA was detected in only 3.6% of seropositives (overall prevalence 0.18%). Logistic regression for anti-HCV showed poor predictive value (AUC 0.546, p = 0.68).
Conclusion: Despite vaccination efforts, a high rate of HBV exposure and waning seroprotection persist among HCWs. The detection of OBI and active HCV in “low-risk” personnel highlights the limitations of current HBsAg-only screening. Epidemiological surveillance should transition to active monitoring of anti-HBc / anti-HBs status and targeted PCR screening, alongside strict adherence to standard precautions by all staff.
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BibTeX
@article{kostinov2026hidden,
title = {{The hidden burden of viral hepatitis B and C in healthcare settings: a cross-sectional study of seroprevalence, predictors, and occult infection}},
author = {Mikhail Kostinov and Olga Isaeva and Ivan Samolygo and Svetlana Erdes and Marina Manina and Albina Pestova and Anton Antishin and Polina Kondrashova and Asadi Mobarhan Fedor and Alexander Novikov and Elena Tanaschuk and Tatiana Androsova and Izabella Khrapunova and Andrey Linok and Marina Loktionova and Naida Magomedova and Nikolay Briko and Aristitsa Kostinova},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1964413},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1964413/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The hidden burden of viral hepatitis B and C in healthcare settings: a cross-sectional study of seroprevalence, predictors, and occult infection
AU - Mikhail Kostinov
AU - Olga Isaeva
AU - Ivan Samolygo
AU - Svetlana Erdes
AU - Marina Manina
AU - Albina Pestova
AU - Anton Antishin
AU - Polina Kondrashova
AU - Asadi Mobarhan Fedor
AU - Alexander Novikov
AU - Elena Tanaschuk
AU - Tatiana Androsova
AU - Izabella Khrapunova
AU - Andrey Linok
AU - Marina Loktionova
AU - Naida Magomedova
AU - Nikolay Briko
AU - Aristitsa Kostinova
PY - 2026
DA - 2026/10/15
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1964413
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1964413/full
AB - Background: Bloodborne viral hepatitis B and C remain critical occupational hazards for healthcare workers (HCWs). Current mandatory screening in some countries, including Russia, relies solely on hepatitis B surface antigen (HBsAg) detection, which may overlook occult infections. This study aimed to evaluate the prevalence, predictors, and occupational risks of HBV (including occult HBV infection) and HCV among HCWs in multidisciplinary facilities. Methods: A cross-sectional observational study of 1,643 HCWs and auxiliary staff was conducted. Blood serum samples were tested for anti-HBc, anti-HBs, and anti-HCV antibodies using ELISA. Seropositive individuals underwent real-time PCR testing to detect HBV DNA and HCV RNA. Multivariable logistic regression was used to identify independent predictors of seropositivity. Results: Anti-HBc IgG was detected in 36.6% of HCWs, demonstrating a strong age gradient (aOR = 1.55 per 10 years of age; p < 0.001), rising from 12.4% in those under 30 to 50% in those over 60. Anti-HBs levels ≥10 mIU/mL were observed in only 54.8% of HCWs, dropping to 29.7% at a stricter threshold (>100 mIU/mL). High anti-HBs titers (100–1,000 mIU/mL) were strongly associated with anti-HBc positivity (aOR = 4.65; p < 0.001). Occult hepatitis B infection (OBI) was detected in 3.1% (95% CI 0.85–7.73%) of tested anti-HBc-positive HCWs, who exhibited lower median anti-HBs concentrations compared to PCR-negative counterparts (7 vs. 165 mIU/mL; p = 0.003). HBV DNA was detected in 4 of 129 HBsAg-negative, anti-HBc-positive participants (3.1%), a finding consistent with possible occult HBV infection. Notably, 75% of OBI cases were classified as low occupational risk. Anti-HCV prevalence was 5%, but HCV RNA was detected in only 3.6% of seropositives (overall prevalence 0.18%). Logistic regression for anti-HCV showed poor predictive value (AUC 0.546, p = 0.68). Conclusion: Despite vaccination efforts, a high rate of HBV exposure and waning seroprotection persist among HCWs. The detection of OBI and active HCV in “low-risk” personnel highlights the limitations of current HBsAg-only screening. Epidemiological surveillance should transition to active monitoring of anti-HBc / anti-HBs status and targeted PCR screening, alongside strict adherence to standard precautions by all staff.
SN - 2296-2565
ER -