An Approach to Preventing Transmission
The dilemma of the hepatitis B surface antigen (HBsAg)-positive physician has been well described.1 He or she has the potential of transmitting hepatitis B to patients, but the risk of transmission is not known. The dilemma lies in whether this risk is great enough to warrant prohibition of clinical practice. A working formulation is necessary in the face of our incomplete knowledge about the risk and even the routes of transmission.
PREVENTION OF TRANSMISSION
What should be done with the HBsAg-positive physician? What can this physician do to prevent transmission? A consensus exists in the handling of the following situations: First, the physician with acute hepatitis B2 should be excluded from patient contact until resolution of the clinical illness and clearance of HBsAg from the serum; and second, the physician documented to have transmitted hepatitis B3 should