Risk of parenterally transmitted hepatitis following exposure to surgery or other invasive procedures: results from the hepatitis surveillance system in Italy.
OBJECTIVE
To evaluate the strength of association between parenterally transmitted viral hepatitis and specific types of invasive procedures.


METHODS
Data from the surveillance system for type-specific acute viral hepatitis (SEIEVA) during the period 1994-1999 were used. The association of acute hepatitis B virus (HBV) and hepatitis C virus (HCV) infection with the potential risk factors (odds ratios (OR)) was estimated comparing 3120 hepatitis B and 1023 hepatitis C cases with 7158 hepatitis A cases, used as controls, by multiple logistic regression analysis.


RESULTS
Most procedures resulted in being associated with the risk of acquiring acute HBV or HCV. The strongest associations were: for HBV infection, abdominal surgery (adjusted OR = 3.9; 95% confidence intervals (CI) = 2.0-7.5), oral surgery (OR = 2.7; 95% CI = 1.6-4.5) and gynaecological surgery (OR = 2.6; 95% CI = 1.2-5.5); for HCV infection, obstetric/gynaecological interventions (OR = 12.1; 95% CI = 5.6-26.3), abdominal surgery (OR = 7.0; 95% CI = 3.2-14.9) and ophthalmological surgery (OR = 5.2; 95% CI = 1.1-23.2). Biopsy and/or endoscopy were associated with HCV, but not with HBV infection.


CONCLUSIONS
Invasive procedures represent an important mode of HBV and HCV transmission. Since a large proportion of the adult general population is exposed to these procedures and an effective HCV vaccine is not yet available, non-immunological means of controlling iatrogenic modes of transmission are extremely important.
Mele
A
A
Laboratory of Epidemiology, Istituto Superiore di Sanità, Rome, Italy.
Spada
E
E
Sagliocca
L
L
Ragni
P
P
Tosti
M E
ME
Gallo
G
G
Moiraghi
A
A
Balocchini
E
E
Sangalli
M
M
Lopalco
P L
PL
Stroffoli
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006506:Hepatitis A / Q000209:etiology* / Q000635:transmission*; D006509:Hepatitis B / Q000209:etiology* / Q000635:transmission*; D006526:Hepatitis C / Q000209:etiology* / Q000635:transmission*; D006801:Humans; D007049:Iatrogenic Disease; D007558:Italy; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology; D012044:Regression Analysis; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects