open access

Vol 73, No 2 (2022)
Case report
Submitted: 2022-03-15
Accepted: 2022-06-10
Published online: 2022-06-29
Get Citation

Reactivation of hepatitis B virus infection in a seafarer: an omitted problem of maritime medicine

Michał Rokicki1, Katarzyna Sikorska23, Małgorzata Sulima2, Marta Gesing14
·
Pubmed: 35781683
·
IMH 2022;73(2):77-82.
Affiliations
  1. University Centre of Maritime and Tropical Medicine, Gdynia, Poland
  2. Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine, Faculty of Health Sciences, Medical University of Gdansk, Gdynia, Poland
  3. Department of Tropical Medicine and Epidemiology, Institute of Maritime and Tropical Medicine, Faculty of Health Sciences, Medical University of Gdansk, Gdynia, Poland
  4. Department of Infectious Diseases, Medical University of Gdansk, Poland

open access

Vol 73, No 2 (2022)
MARITIME MEDICINE Case report
Submitted: 2022-03-15
Accepted: 2022-06-10
Published online: 2022-06-29

Abstract

Infection with hepatitis B virus (HBV), despite the implementation of extensive preventive measures, has
remained one of the biggest health problems worldwide. There are still people not covered by the compulsory
vaccination programme and carriers of an actively replicating virus among professionally active
seafarers. The article is based on a case report of a seafarer with life-threatening reactivation of long-term
uncontrolled HBV infection that resulted in decompensated cirrhosis and liver transplant. The case shows
clinical aspects of chronic hepatitis B and contributes to discussion about HBV infection with regard to
seafarers. The article also analyses the current legal regulations and guidelines in terms of preventing
new infections and detecting people already infected with HBV. Considering the specific nature of work
on seagoing ships, it is justified to recognise the seafaring as a profession with a high risk of HBV infection.
Monitoring the course of the disease can prevent reactivation of inflammatory process and serious
consequences of chronic hepatitis B during a cruise. The elementary issue is specific prophylaxis, that is,
covering the unvaccinated persons with the vaccination programme. The prevalence of HBV infection and
the specifics of the seafarer labour market require development of new international regulations, which
will unify Pre-Employment Medical Examination (PEME) protocols and take into consideration compulsory
vaccination.

Abstract

Infection with hepatitis B virus (HBV), despite the implementation of extensive preventive measures, has
remained one of the biggest health problems worldwide. There are still people not covered by the compulsory
vaccination programme and carriers of an actively replicating virus among professionally active
seafarers. The article is based on a case report of a seafarer with life-threatening reactivation of long-term
uncontrolled HBV infection that resulted in decompensated cirrhosis and liver transplant. The case shows
clinical aspects of chronic hepatitis B and contributes to discussion about HBV infection with regard to
seafarers. The article also analyses the current legal regulations and guidelines in terms of preventing
new infections and detecting people already infected with HBV. Considering the specific nature of work
on seagoing ships, it is justified to recognise the seafaring as a profession with a high risk of HBV infection.
Monitoring the course of the disease can prevent reactivation of inflammatory process and serious
consequences of chronic hepatitis B during a cruise. The elementary issue is specific prophylaxis, that is,
covering the unvaccinated persons with the vaccination programme. The prevalence of HBV infection and
the specifics of the seafarer labour market require development of new international regulations, which
will unify Pre-Employment Medical Examination (PEME) protocols and take into consideration compulsory
vaccination.

Get Citation

Keywords

hepatitis B, seafarers, chronic hepatitis, hepatitis reactivation, maritime medicine, epidemiology, vaccination

About this article
Title

Reactivation of hepatitis B virus infection in a seafarer: an omitted problem of maritime medicine

Journal

International Maritime Health

Issue

Vol 73, No 2 (2022)

Article type

Case report

Pages

77-82

Published online

2022-06-29

Page views

4364

Article views/downloads

793

DOI

10.5603/IMH.2022.0012

Pubmed

35781683

Bibliographic record

IMH 2022;73(2):77-82.

Keywords

hepatitis B
seafarers
chronic hepatitis
hepatitis reactivation
maritime medicine
epidemiology
vaccination

Authors

Michał Rokicki
Katarzyna Sikorska
Małgorzata Sulima
Marta Gesing

References (16)
  1. Nguyen MH, Wong G, Gane E, et al. Hepatitis B Virus: Advances in Prevention, Diagnosis, and Therapy. Clin Microbiol Rev. 2020; 33(2).
  2. Global Hepatitis Report 2017. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
  3. Smalls DJ, Kiger RE, Norris LB, et al. Hepatitis B virus reactivation: risk factors and current management strategies. Pharmacotherapy. 2019; 39(12): 1190–1203.
  4. European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017; 67(2): 370–398.
  5. Levrero M, Zucman-Rossi J. Mechanisms of HBV-induced hepatocellular carcinoma. J Hepatol. 2016; 64(1 Suppl): S84–S8S101.
  6. Raimondo G, Locarnini S, Pollicino T, et al. Update of the statements on biology and clinical impact of occult hepatitis B virus infection. J Hepatol. 2019; 71(2): 397–408.
  7. United Nations Conference on Trade and Development. Review of Maritime Transport, Geneva 2019 , pp 81-109; ISBN: 9789210043021. https://doi.org/10.18356/17932789-en.
  8. Skrzeszewska K. Seafarers Labor Market as an Example of The Global Market With Perfect Mobility of Human Capital /Badanie rynku pracy marynarzy. Studia Ekonomiczne. 2014; 196: 114–125.
  9. Gish RG, Sollano JD, Lapasaran A, et al. Chronic hepatitis B virus in the Philippines. J Gastroenterol Hepatol. 2016; 31(5): 945–952.
  10. Çakır E. Fatal and serious injuries on board merchant cargo ships. Int Marit Health. 2019; 70(2): 113–118.
  11. Oldenburg M, Baur X, Schlaich C. Occupational risks and challenges of seafaring. J Occup Health. 2010; 52(5): 249–256.
  12. Horneland AM, Stannard SL. Decision aid for the use of additional tests during the pre-employment medical examination (PEME) of seafarers. Int Marit Health. 2017; 68(2): 90–98.
  13. ILO/IMO Guidelines on the medical examination of seafarers. Appendix E. Introduction. ISBN 978-92-2-127463-6.
  14. Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, Guidelines Review Committee, WHO 2015, ISBN: 978 92 4 154905 9. https://www.who.int/publications/i/item/9789241549059.
  15. Matejuk A, Simon K. Impact of vaccination against HBV on hepatitis B incidence in Opolskie province in 2007-2011. Przegl Epidemiol. 2015; 69(1): 27–31, 135.
  16. Svicher V, Salpini R, Malagnino V, et al. New markers in monitoring the reactivation of hepatitis B virus infection in immunocompromised hosts. Viruses. 2019; 11(9).

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