title: Human immunodeficiency virus, hepatitis B, and hepatitis C seroprevalence in a Canadian trauma population.
abstract: BACKGROUND
  The current seroprevalence of human immunodeficiency virus (HIV), hepatitis B, and hepatitis C in the Canadian trauma population is unknown. Establishing the seroprevalence of these diseases is vital for education, postexposure prophylaxis, and counseling, and to establish potential screening guidelines. The purpose of this study was to determine the seroprevalence of HIV, hepatitis B, and hepatitis C in the trauma population of London, Ontario, Canada.
  
  
  METHODS
  All adult (aged > or = 18 years) trauma patients treated by the trauma team at London Health Sciences Centre were prospectively studied from January to December 2003. The study was conducted as a linked, confidential serosurvey with delayed full disclosure. Serum was analyzed for HIV, hepatitis C antibody, and Hepatitis B surface antigen.
  
  
  RESULTS
  A total of 287 (76%) of 377 consecutive trauma patients had blood testing completed. Of the 287 patients tested, 1 (0.3%) was positive for hepatitis B, 8 (2.8%) were positive for hepatitis C, and no patients tested positive for HIV. Hepatitis C-positive patients were predominantly men (63%) with a mean age of 46 years and a mean Injury Severity Score of 19; 63% were injured in a motor vehicle crash, and 88% were discharged alive. There were no statistically significant differences in the demographic and injury profiles from the hepatitis C-negative patients (p > 0.2 for all).
  
  
  CONCLUSIONS
  This is the first study to determine the rates of HIV, hepatitis B, and hepatitis C in the Canadian trauma population. Our trauma population demonstrated a threefold higher hepatitis C seroprevalence rate compared with the general population. Hepatitis C poses the highest risk to the trauma team of the three bloodborne diseases studied. With no vaccine or postexposure prophylaxis currently available for hepatitis C, this study highlights the importance of prevention and the strict use of universal precautions in the setting of trauma.
authors.affiliation: Trauma Program, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Xeroulis
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
authors.forename: Tanya Charyk
authors.initials: TC
authors.lastname: Stewart
authors.forename: Rob
authors.initials: R
authors.lastname: Lannigan
authors.forename: Daryl
authors.initials: D
authors.lastname: Gray
authors.forename: Richard
authors.initials: R
authors.lastname: Malthaner
authors.forename: N Gil
authors.initials: NG
authors.lastname: Parry
authors.forename: Murray
authors.initials: M
authors.lastname: Girotti
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D015528:HIV Seroprevalence; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009864:Ontario / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014947:Wounds and Injuries / Q000150:complications / Q000453:epidemiology* / Q000821:virology