title: Risk of hepatitis B virus transmission by diagnostic hysteroscopy.
abstract: Few data are available in the literature concerning the efficacy of standard hysteroscope disinfection procedures to prevent hepatitis B transmission. The aim of the present study was to determine the risk of hepatitis B virus (HBV) transmission during hysteroscopy among anti-HBc-seropositive women. Serum and hysteroscopic samples were collected from 62 women after diagnostic hysteroscopy. All samples were tested for serologic HBV markers. Polymerase chain reactions (PCR) were carried out to amplify regions C and S of the viral genome and only samples amplified by both pairs of primers were considered to be positive. Anti-HBc was repeatedly reactive in 48 (77%) of 62 serum samples, and HBsAg was detected in 8 (13%). At least one HBV serologic marker was found in 49 (79%) samples. Only one sample was HBsAg positive and anti-HBc negative. HBV-DNA was detected by PCR in 7 serum samples but in only 3 hysteroscopic samples obtained just after hysteroscopy. It is noteworthy that high levels of anti-HBc IgM were detected in one HBsAg-negative patient who showed an HBV-DNA-positive hysteroscopic sample. An elevated sample/cut-off ratio for anti-HBc IgM suggests recent infection and reinforces the need for testing for HBsAg and anti-HBc before hysteroscopy, since acute hepatitis B can be clinically asymptomatic. Viral DNA was not detected in any hysteroscopic samples collected after washing and disinfecting procedures with glutaraldehyde. We conclude that HBV-DNA can be found in the hysteroscope soon after hysteroscopy, but standard disinfecting procedures are effective in viral removal.
authors.affiliation: Departamento de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: N C
authors.initials: NC
authors.lastname: Santos
authors.forename: J R R
authors.initials: JR
authors.lastname: Pinho
authors.forename: M F
authors.initials: MF
authors.lastname: Lemos
authors.forename: R C
authors.initials: RC
authors.lastname: Moreira
authors.forename: C M C
authors.initials: CM
authors.lastname: Lopes
authors.forename: M T J
authors.initials: MT
authors.lastname: Sacilotto
authors.forename: M
authors.initials: M
authors.lastname: Tacla
authors.forename: W S
authors.initials: WS
authors.lastname: Pinheiro
authors.forename: L O
authors.initials: LO
authors.lastname: Ramos
mesh_terms: D015415:Biomarkers / Q000032:analysis / Q000097:blood; D004279:DNA, Viral / Q000032:analysis; D004203:Disinfection; D005260:Female; D006509:Hepatitis B / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000032:analysis* / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D016133:Polymerase Chain Reaction; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies