Custo do teste Anti-HBs pós-vacinação primária em relação ao manejo para hepatite B pós-exposição à material biológico entre trabalhadores da área da saúde
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2018-05-11
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Universidade Federal de Goiás
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INTRODUCTION: Hepatitis B virus (HBV) infection is a worldwide public health problem and
the cost of treatment for hepatitis B is high. Work related accidents with biological material
among health care workers present a risk of transmission of this virus. The primary preventive
measure against HBV is vaccination, followed by an anti-HBs test one to two months after the
final dose of the vaccine, however this test is not part of the pre-exposure routine in Brazilian
public health. OBJECTIVES: To compare the direct medical cost, from the public health
perspective, of the evaluation of pre-exposure serological status vs the post-exposure
management of hepatitis B virus-related occupational exposure among exposed health care
workers. The specific objectives were to describe sociodemographic and job characteristics, to
classify the profile of accidents, to identify the vaccination history and serological status for
hepatitis B, and to quantify the direct cost of post-exposure management and preventive
measures for hepatitis B. METHODOLOGY: A cross-sectional, descriptive study with a partial
economic evaluation of the cost analysis type, focusing on direct medical costs among health
care workers exposed to biological material in the municipality of Goiania, accidents registered
in the SINAN-NET database in the period 2006-2016. RESULTS: This study included 7,265
recorded accidents with biological material, being predominantly female health care workers
(80.5%), nursing staff (55.2%) with secondary education (43.0%), with accidents involving
blood (74.4%), those being percutaneous (72.4%). The mean age was 34 years, with the age
group 21-30 years being the most predominant. Among those exposed, 85.1% received all
three doses of the vaccine, and of those, 44.6% performed the anti-HBs test at the time of
the accident. The prevalence of HBsAg among known source patients was 1.8% (95% CI 1.0-
3.2). The costs analyzed in this study were the anti-HBs test, HBsAg test, IGHAHB and a
worker health office visit. Considering this history, the direct cost of occupational post-
exposure management for hepatitis B among victims was evaluated in four different scenarios,
and the direct cost ranged from R$ 3,615.52 (Int$ 6.573,67) to R$ 835,751.52
(Int$1.519.548,22). The post-exposure scenarios for HBV that presented the greatest direct
medical cost impact for public health were the scenarios in which the porkers had anti-HBs
<10 IU/ml and were exposed to an HBsAg-positive, unknown source patient. The direct cost
of performing the anti-HBs test after primary vaccination among 7.265 workers was R$
207,415.75 (Int$ 377,119.54). CONCLUSION: The direct per capita cost of post-exposure
management was higher than the direct cost of performing the pre-exposure anti-HBs test,
money that could be invested in policies that protect the health of the worker.
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SOUZA, Camila Lucas de. Custo do teste Anti-HBs pós-vacinação primária em relação ao manejo para hepatite B pós-exposição à material biológico entre trabalhadores da área da saúde. 2018. 115 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2018.