Association of tattooing and hepatitis C virus infection: A multicenter case-control study

Abstract

Although injection drug use (IDU) and blood transfusions prior to 1992 are well-accepted risk factors for hepatitis C virus (HCV) infection, many studies that evaluated tattooing as a risk factor for HCV infection did not control for a history of IDU or transfusion prior to 1992. In this large, multicenter, case-control study, we analyzed demographic and HCV risk factor exposure history data from 3,871 patients, including 1,930 with chronic HCV infection (HCV RNA-positive) and 1,941 HCV-negative (HCV antibody-negative) controls. Crude and fully adjusted odds ratios (ORs) of tattoo exposure by multivariate logistic regression in HCV-infected versus controls were determined. As expected, IDU (65.9% versus 17.8%; P < 0.001), blood transfusion prior to 1992 (22.3% versus 11.1%; P < 0.001), and history of having one or more tattoos (OR, 3.81; 95% CI, 3.23-4.49; P < 0.001) were more common in HCV-infected patients than in control subjects. After excluding all patients with a history of ever injecting drugs and those who had a blood transfusion prior to 1992, a total of 1,886 subjects remained for analysis (465 HCV-positive patients and 1,421 controls). Among these individuals without traditional risk factors, HCV-positive patients remained significantly more likely to have a history of one or more tattoos after adjustment for age, sex, and race/ethnicity (OR, 5.17; 95% CI, 3.75-7.11; P < 0.001). Conclusion: Tattooing is associated with HCV infection, even among those without traditional HCV risk factors such as IDU and blood transfusion prior to 1992. (HEPATOLOGY 2013;57:2117-2123 As new and better medications for the treatment of HCV become available, [13][14][15] measures to increase detection rates and engagement in care are paramount. In the last decade, an expanding body of research has emerged, evaluating both traditional and nontraditional risk factors for HCV infection in an effort to increase the yield from costly yet potentially life-saving screening efforts. 7,[16][17][18][19] Most recently, the US Department of Health and Human Services issued an action plan for the prevention, care, and treatment of viral hepatitis, setting goals to increase the proportion of persons who are aware of their HCV infection from 45% to 66%, and to reduce the number of new cases of HCV infection by 25%. 20In contrast to the overwhelming evidence implicating IDU in HCV acquisition, the association between HCV transmission and other suspected risk factors such as tattooing is more controversial. Although some studies have demonstrated an association between tattoos and HCV infection, others have not.21 Prior studies that examined tattooing behavior and HCV

Most common HCV genotypes in patients from north-eastern Croatia

“…Similar ndings were reported in Central Africa (29), Brazil (10) and Jordan (30). Unexpectedly, however, factors such as intravenous drug usage and tattooing did not signi cantly associate with HCV infection in north-eastern Croatia, contrary to data from other studies (31)(32)(33). Whether this is due to the small number of participants in our study remains to be elucidated.…”

Prevalence of Hepatitis B Virus and Hepatitis C Virus Infections among Beauticians in Quy Nhon City, Binh Dinh Province, Vietnam

“…[32][33][34][35] Like other studies, 5,6,23,24,28,36 our results also showed no statistically significant association between possible occupational risk factors for HBV infection among beauticians. However, some studies have suggested that beauticians are a high-risk group for HBV and HCV infections based on the statistically significant difference in prevalence among case and control groups, 24,36,37 or by comparing HBV infected cases with HAV infected cases as a control group. 6 A systematic review and meta-analysis found that tattooing was a risk factor for HCV transmission in particular, but only in a non-professional setting.…”

“…Several studies reported that beauty treatment activities, especially shaving and tattooing, might be associated with HBV and HCV infections. [5][6][7][23][24][25] Our study demonstrated that the prevalence of HBV infection among beauticians in Quy Nhon City, Binh Dinh province was 7.3% (95% CI: 4.4-11.3). This result was similar to the reported global HBV prevalence, indicating that Viet Nam was classified as a region of high-intermediate level of HBV infection (5-8%).…”

Cost-effectiveness of screening for hepatitis C in Canada

“…For example, we did not investigate the economic benefit of screening high-risk groups such as immigrants from high-burden countries, emergency department or in-hospital populations, skin-piercing practitioners or low-income groups. Recent studies in the US have shown that populations such as patients undergoing hemodialysis, 70 health care professionals, 71,72 skin-piercing practition ers 73 and low-income groups 74 have contributed substantially to the overall prevalence of chronic HCV infection in that country. Screening for chronic HCV infection within these high-risk groups in Canada could be explored as an alternative strategy.…”