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Doctors’ hepatitis not seen as a risk

Peter Nguyen was a medical student when his school learned he had tested positive for the hepatitis B virus. He said he was blackballed by administrators and forced to halt his studies.

‘‘I knew the stigma’’ that came with a hepatitis diagnosis, Nguyen said. But he thought a medical school, of all places, would understand. ‘‘I came there expecting help. Instead, I was greeted with discrimination.’’

His prospects are a lot brighter today. The Department of Justice recently declared in a legal settlement that hepatitis B patients are protected by federal disability law. Separately, US health officials have issued revised guidelines that make it clear health care workers and students who carry the hepatitis B virus — HBV — generally pose little or no risk to ­patients.


The new guidelines and the Justice Department settlement remove barriers to practice, advocates say handing HBV-positive professionals and students powerful tools to combat discrimination.

‘‘We no longer have to wring our hands,’’ said Joan Block, executive director and cofounder of the Hepatitis B Foundation. She said Nguyen was among several students who contacted the foundation in 2011 to report they had been forced out of school or had their admissions rescinded because of an HBV diagnosis.

Hepatitis B is a contagious and potentially fatal liver disease spread through blood and other bodily fluids. The virus is most commonly transmitted through unprotected sex. Intravenous drug use is another risk factor. It can also be passed from an infected mother to her baby at birth, which is how Nguyen contracted it.

As many as 1.4 million Americans have chronic hepatitis B. It’s not clear how many are health practitioners. But some 25 percent of medical and dental students — and many practicing doctors, surgeons, and dentists — were born to mothers from countries in Asia and other regions where the virus is endemic, according to the Centers for Disease Control and Prevention.


The CDC last issued guidelines for management of health workers and students with hepatitis B in 1991. A lot had changed in two decades. Universal infant vaccination had slashed the number of new cases by more than 80 percent. New drug therapies had proved effective at reducing the amount of virus in a carrier’s blood to very low or undetectable levels, minimizing the risk of transmission.

And there had been only a single case of hepatitis B transmission from a health provider to a patient at least since 1991 — an orthopedic surgeon who was unaware of his hepatitis infection and had a very high amount of the virus in his body. He infected two to eight patients, according to the CDC.

Dr. John Ward, director of the CDC’s Division of Viral Hepatitis, said the new guidelines offer a ‘‘powerful message that in the great majority of clinical encounters between a health care provider and a patient, there is minimal or no risk of hepatitis B virus transmission.’’

The CDC guidelines were cited by the Justice Department in March as it settled with the state-run University of Medicine and Dentistry of New Jersey over claims it had violated the Americans with Disabilities Act by excluding two applicants with hepatitis B.