Is there a benefit for health care workers in testing HIV, HCV and HBV in routine before elective arthroplasty?

Winkelmann, Marcel; Sorrentino, Jose; Klein, Marina B.; Macke, Christian; Mommsen, Philipp; Brand, Stephan; Schröter, Christian; Krettek, Christian; Zeckey, Christian

doi:10.1016/j.otsr.2016.02.012

Cited by 14 publications

(17 citation statements)

References 19 publications

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“…Studies in proxy populations included several large studies analysing test results of HBV screening during pregnancy and the national blood donor surveillance. Other evidence for the GP was mostly derived from large cross-sectional screening studies in hospital emergency departments or medical practices [25,32,36,50,100,114,115]. All these populations may represent the GP but it should be taken into account, that there might be a selection bias as population groups possibly differ in health care-seeking behaviour.…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of Hepatitis B, C and D in Germany: A scoping review

et al. 2020

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BackgroundGermany is considered to be a low prevalence country for viral Hepatitis B, C and D (HBV, HCV, HDV). However, the burden of disease can be high among subpopulations. To meet the world Health Organization (WHO) viral hepatitis (VH) elimination goals, a national strategy was developed by the German government in 2016. We performed a scoping review to understand the baseline epidemiological situation in Germany regarding burden of disease, sequelae and care of HBV, HCV and HDV as a reference to monitor the progress of the national VH elimination and to identify further knowledge gaps and research needs.

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Section: Discussionmentioning

confidence: 99%

The epidemiology of Hepatitis B, C and D in Germany: A scoping review

et al. 2020

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“…Several studies have suggested that HIV screening before elective orthopaedic surgery, especially for patients with risk factors, may be beneficial to surgeons [19,20]. Amongst healthcare workers, surgeons have the highest incidence of exposure reported as approximately 12 percutaneous blood exposures per person per year [21].…”

Section: Introductionmentioning

confidence: 99%

The seroprevalence of HIV in patients undergoing lower limb Total Joint Arthroplasty (TJA) in South Africa

Maharaj

Pietrzak

Sikhauli

et al. 2020

SICOT-J

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Aim: The aim was to assess the seroprevalence of Human Immunodeficiency Virus (HIV) in non-haemophilic patients undergoing primary Total Joint Arthroplasty (TJA) at an academic hospital in South Africa. Methods: A retrospective review of all Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) patients from January 2017 to December 2018 was conducted. All patients awaiting TJA were offered HIV screening and their demographic data were recorded. Consenting patients were tested or the refusal of testing was documented. The CD4+ T-cell count (CD4+) and viral load (VL) was measured for all HIV-positive patients and newly diagnosed patients were initiated on Highly Active Antiretroviral Treatment (HAART). Results: We included 1007 patients in the study. The TJA population HIV seroprevalence was 10.7% (n = 108). The seroprevalence for THA was 14.9% (n = 78) and that for TKA was 6.2% (n = 30). There were 93 patients (9.2%) who refused screening. There were 12 (15.4%) and 3 patients (10%) that were newly diagnosed in the THA and TKA seropositive populations, respectively. The average CD4+ for THA and TKA was 569 cells/mm3 (105–1320) and 691 cells/mm3 (98–1406), respectively. The VL was undetectable in 75.9% (n = 82) of HIV-positive patients. Overall 12 HIV-positive patients (11.12%) had CD4+ <200 cells/mm3, 8 of these patients (66%) were newly diagnosed. The average age of the seropositive population was 58 ± 6.5 years and 66 ± 8.5 years for THA and TKA, respectively (p = 0.03). Femoral head osteonecrosis was the underlying pathology for 65.38% (n = 51) of seropositive patients for THA. Conclusion: The seroprevalence of HIV in patients undergoing THA in our South African institution is greater than the seroprevalence in the general population. The seroprevalence of HIV in THA is significantly greater than that in TKA. This may reflect the association between HIV, HAART and hip joint degeneration. Our findings draw attention to the significant burden HIV has on TJA.

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“…Winkelmann and colleagues [3] examined a population of patients undergoing elective joint replacement to determine whether preoperative screening was worth the costs of identifying infections. In the 1534 patients screened, they found 21 patients with hepatitis C, 10 patients with hepatitis B, and one patient with HIV infection.…”

Section: Where Do We Need To Go?mentioning

confidence: 99%

“…Each newly diagnosed infection cost 7250 euros. The authors estimated ''the risk of hepatitis C transmission from an index patient with unknown status of infectiousness to health care worker after percutaneous contact to blood is [3].…”

Section: Where Do We Need To Go?mentioning

confidence: 99%