Prevalence of hepatitis B in a high-risk setting: a serologic study of patients and staff in a pediatric oncology unit

The prevalence of serologic markers for hepatitis B virus (HBV) among 188 patients and 158 employees in a pediatric oncology unit was evaluated. Evidence of past or present HBV infection was detected in 33 patients (18%) and in 25 employees (16%). The prevalence was higher among patients receiving chemotherapy (19%) than among those not receiving chemotherapy (7%). The prevalence of HBV serologic markers, while much higher than generally found among healthy children in the United States, was low compared to previously reported prevalences in such settings, and may reflect the use in recent years of blood and blood products screened by "third generation" methods (radioimmunoassay and reversed passive hemagglutination) for hepatitis B surface antigen and the use of all volunteer blood donors. This prevalence suggests that perhaps there is less urgent need for the use of hepatitis B immune globulin and hepatitis B vaccine (when it becomes available) in oncology units than had been anticipated from earlier data in oncology units.