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ER physician Born w hep B
May 20, 2013

Hi I have been dx with hep b. most likely I was born w it. My mother has chronic hep b as well. I was told I'm not infectious and my viral load considered undetectable. My concern is can I still practice emergency medicine? Do i have to disclose this w my employer? Thank you.

Response from Dr. Taylor

People who have chronic hepatitis B virus infection may work as health care workers. There are a number of things to consider regarding the health of your patients and decreasing risk to them.

Factors to discuss with your doctor include your hepatitis B viral load, whether you will benefit from treatment for yourself and to reduce the risk of spread of hepatitis B to others, and the types of care you will or should not be providing. There are higher risk (surgery) and lower risk (primary care, without procedures) types of medicine.

Rules may vary from country to country. In the U.S. for example helpful guidelines include, "Society for Healthcare Epidemiology of America (SHEA)SHEA Guideline for Management of Healthcare Workers Who Are Infected with Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus," Infection Control and Hospital Epidemiology March 2010, vol. 31, no. 3, written by Henderson and colleagues. These may be found at may be found at http://www.shea-online.org/Assets/files/guidelines/BBPathogen_GL.pdf

In my view the most ethical thing as a physician would be to follow the SHEA guidelines, and find a confidential board to work with, to follow and make sure your HBV DNA remains undetectable, and that you are following the other recommendations. This does NOT have to be your employer.



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