[波兰预防丙型肝炎和艾滋病毒感染的职业医学服务指南]。

Medycyna pracy Pub Date : 2024-11-28 Epub Date: 2024-09-26 DOI:10.13075/mp.5893.01548
Andrzej Marcinkiewicz, Jolanta Walusiak-Skorupa, Paweł Wdówik, Dorota Zarębska-Michaluk, Małgorzata Inglot, Magdalena Władysiuk, Tomasz Jan Prycel, Robert Flisiak
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引用次数: 0

摘要

通过考虑病毒感染的诊断和健康教育,建立新的医疗保健模式,旨在实现世界卫生组织《全球卫生部门 2022-2030 年病毒性疾病战略》的目标。与欧洲相比,波兰是乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)以及人类免疫缺陷病毒(HIV)感染率较高的国家之一。另一个挑战是,由于主要来自乌克兰战争的移民的影响,流行病学形势不断变化。文章介绍了当前 HCV 和 HIV 诊断指南,并介绍了职业健康服务(OHS)在传染病一级和二级预防中的作用。文章认为应扩大定期检查的范围,将迄今为止尚未进行过检查的医护人员的 HBV、HCV 和 HIV 感染诊断包括在内。如果在就业前常规检查或特定职业接触定期检查中发现丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)或γ-谷氨酰转肽酶(GGT)水平异常,则必须采取进一步措施,排除或确认 HBV 或 HCV 感染,并在初级保健中进行进一步处理,随后进行定期检查。会议指出,有必要关注任何可能预示着 HBV、HCV 和/或 HIV 感染的症状,进行额外的诊断检测(例如,护理点),并在结果呈阳性的情况下确定下一步措施。它强调有必要向患者提供有针对性的信息,包括注意确保移民工人了解下一步措施。建议职业健康与安全办公室开展教育活动,通过卫生政策方案以及与雇主合作开展更广泛的活动,提高对艾滋病毒、丙型肝炎病毒和乙型肝炎病毒感染的健康意识。Med Pr Work Health Saf.2024;75(5).
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[Guidance for the occupational medicine service regarding the prevention of hepatitis C and HIV infection in Poland].

The set up of new healthcare models by taking into account diagnosis and health education of the viral infection, aims to achieve the goals of the World Health Organization Global Health Sector Strategy on viral diseases for 2022-2030. In comparison to Europe, Poland is ranked among countries with an moderate prevalence of hepatitis B and C virus (HBV and HCV), also human immunodeficiency virus (HIV). An additional challenge is the changing epidemiological situation due to the impact of immigrants, resulting mainly from the war in Ukraine. The article presents current guidance for HCV and HIV diagnosis and presents the role of occupational health service (OHS) for primary and secondary prevention of the infectious diseases. It was considered to expand the scope of periodic examinations to include diagnosis of HBV, HCV and HIV infections among health care workers, who have not had it performed so far. In the case of abnormal level of alanine aminotransferase (ALT), aspartate aminotransferase (AST) or γ-glutamyl transpeptidase (GGT) found during routine pre-employment or periodic examinations for specific occupational exposures and it is considered crucial to implement further measures to exclude or confirm HBV or HCV infection, with indications for further management in primary care, and followed by subsequent periodic examinations. The need to pay attention to any symptoms that may indicate HBV, HCV and/or HIV infection, to perform additional diagnostic tests (e.g., point of care), and to determine the next steps in case of positive result was indicated. It emphasized the need to tailor the delivery of information to the patient, including taking care to ensure that immigrants' workers understand the next steps. It was recommended that the OHS conduct educational activities to raise health awareness of HIV, HCV, HBV infections, both through health policy programs as well as through broader activities in cooperation with the employer. Med Pr Work Health Saf. 2024;75(5):485-494.

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