title: Risk of parenterally transmitted hepatitis following exposure to surgery or other invasive procedures: results from the hepatitis surveillance system in Italy.
abstract: 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.
authors.affiliation: Laboratory of Epidemiology, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mele
authors.forename: E
authors.initials: E
authors.lastname: Spada
authors.forename: L
authors.initials: L
authors.lastname: Sagliocca
authors.forename: P
authors.initials: P
authors.lastname: Ragni
authors.forename: M E
authors.initials: ME
authors.lastname: Tosti
authors.forename: G
authors.initials: G
authors.lastname: Gallo
authors.forename: A
authors.initials: A
authors.lastname: Moiraghi
authors.forename: E
authors.initials: E
authors.lastname: Balocchini
authors.forename: M
authors.initials: M
authors.lastname: Sangalli
authors.forename: P L
authors.initials: PL
authors.lastname: Lopalco
authors.forename: T
authors.initials: T
authors.lastname: Stroffoli
mesh_terms: 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