The Relationship Between the Methods of Male Circumcision Procedures Used in the Past and the Prevalence of Viral Hepatitis

Abstract

ÖZObjective: The study was designed to evaluate the relationship between the methods of circumcision procedures used in the past and hepatitis B surface antigen (HBsAg), anti-HBs and anti-hepatitis C virus (HCV) positivity. Materials and Methods: Within the scope of "Public Hepatitis Awareness Activities" executed by the Viral Hepatitis Society, volunteer participants who were admitted to primary healthcare centers across the Turkey, were screened for HBsAg, anti-HBs and anti-HCV positivity. A standard questionnaire form regarding their circumcision procedure in the past was applied via face-to-face interview method to each participant while their blood samples were collected for the analysis of hepatitis B virus and HCV positivity. Results: HBsAg, anti-HBs and anti-HCV positivity rates were 3.6%, 9.9% and 0.6% respectively. HBsAg positivity was significantly higher in group of participants who have been circumcised by a traditional non-medical person than in the other group of subjects who have been circumcised by a health professional (3.3% vs 5.3%, p=0.003

HIV, syphilis, and hepatitis B virus infection and male circumcision in five Sub-Saharan African countries: Findings from the Population-based HIV Impact Assessment surveys, 2015–2019

“…In our analysis, multivariable models demonstrated that male circumcision significantly reduced the odds of testing positive for a syphilis infection or HIV. These findings, along with previous research, suggest that syphilis and HIV are significantly lower among circumcised men compared to uncircumcised men [ 8 – 13 , 35 , 36 ]. Given the cross-sectional study design of the PHIA surveys, our analysis could not distinguish if syphilis infection predated circumcision.…”

A Nationwide Community Survey of Prevalence of Circumcision among Egyptian Children and Risk of Hepatitis B Viral Infection

“…This may return to the fact that most of the circumcisions were carried out at private clinics and healthcare facilities and were performed mainly by doctors where sterilized materials were used thus decreasing the likelihood of transmission of HBV infection. Moreover, in other studies, where children were circumcised by traditional non-medical providers, showed significant higher values of positive HBV markers than those circumcised by doctors and other medical staff [21], [33].…”

“…The findings of the current study showed that the majority of MCs were performed by doctors and other healthcare team and more than 57% were done in private clinics, while barbers were the main providers for circumcision in Pakistan [20]. In Turkey, the majority of circumcision were done at home and by health technicians [21]. Non-medical personnel who perform circumcision as barbers and traditional healers most probably use unsterilized sharp equipment and use the same equipment (non-disposable) for many persons.…”

“…On the contrary, studies in Nigeria [30], [31] [32] found a significant association between history of circumcision and HBV transmission among children. Moreover, circumcision performed by barbers in Pakistan [33] and Turkey [21] was associated with HBV infection.…”

The Follow-up of HBsAg Carrier Pregnant Women and Their Infants: Evaluation of the Clinical Results of a “Patient follow-up and Treatment Algorithm”

“…Ülkemizde yaklaşık 3 milyon Hepatit B virusu (HBV) taşıyıcısı olduğu tahmin edilmekle birlikte farklı dönemlerde yapı-lan taramalarda yıllar içinde HBsAg seroprevelansının anlamlı derecede azalmakta olduğu bildirilmektedir (5,7,25) . Ancak yapılan çalışmalar doğrultusunda halen Türkiye, HBsAg pozitifliği prevalansının % 2-7, HBV ile karşılaşma prevalansının ise % 20-60 olması nedeniyle orta endemisite bölgesi olarak kabul edilmektedir (1,28) .…”