Is Pre-Endoscopy Hepatitis B and C Testing Useful?

Abstract

Objective: We determined the seroprevalence of HBV and HCV before endoscopic procedures and assessed transmission of hepatitis B and C viruses during endoscopic procedures. Materials and Methods:In total, 2690 consecutive participants who underwent upper gastrointestinal endoscopy under the Early Diagnosis of Gastric Cancer Pilot Project were enrolled in this study. Their medical records, demographic properties, and endoscopic diagnoses were reviewed. HBsAg and anti-HCV serology of all participants was examined before endoscopic procedures. Results:The seroprevalence of HBS(+) was 2.7% and of HCV(+) was 0.2%. The prevalence of HBV infection indicated intermediate endemicity. HCV(+) rates were higher in participants who had undergone endoscopy previously (p = 0.020). Conclusion:Pre-endoscopy determination of hepatitis serology of patients is beneficial to avoid transmission of hepatitis B and C viruses

How useful is routine pre-endoscopy viral screening?

“…This disparity may be due to the fact that HBV prevalence variation exists among different groups of people in the society. 13 However, our finding is comparable to 2.7% obtained by Cakabay et al 14 and the 2.8% obtained by Gulsen et al 15 among patients undergoing digestive endoscopy in Turkey, which all fall within intermediate endemicity.…”

“…Contrary to our finding, Cakabay et al in Turkey found increased seroprevalence of HCV among patients who had previous endoscopy. 14 Since no effort was made to exclude other possible sources of infection in these patients, a causal relationship between the procedures and infection cannot be adequately established.…”

“…While several epidemiologic studies from different countries have suggested an association between GI endoscopy and HCV infection, their relevance may be limited because they are all observational studies that did not establish patient-to-patient transmission by means of genetic studies. 14,16,[34][35][36][37][38][39][40][41] It is not known whether the current generally accepted standard of endoscope reprocessing was adhered to in the majority of the cases. Also, general infection control practice compliance was not evaluated in these studies, bearing in mind that improper use or reuse of multiple dose vials and syringes for sedation are now recognized as an important risk factor for pathogen transmission.…”