title: Relationship of cosmetic procedures and drug use to hepatitis C and hepatitis B virus infections in a low-risk population.
abstract: We conducted an anonymous cross-sectional seroprevalence study of a population with a low frequency of injection drug use to determine whether persons with a history of cosmetic procedures, such as tattooing and body piercing, or intranasal drug use were at increased risk for hepatitis C virus (HCV) or hepatitis B virus (HBV) infection. Students 18 years and older from eight college campuses in Houston, Texas, were invited to participate in the study. Of the 7,960 who completed a self-administered questionnaire and provided a blood sample, 5,282 U.S.- or Canadian-born participants were analyzed. Their median age was 21, 62% were female, 42% were white, 26% black, 22% Hispanic, and 10% Asian or other. Two percent reported injection drug use, 13.7% intranasal drug use, 21.2% body piercings, and 25.2% tattoos. The overall prevalence of HCV infection was 0.9% and of HBV infection was 5.2%. Higher HCV prevalence was independently associated with increasing age (odds ratio [OR] per year = 1.11; 95% confidence interval [CI] = 1.08-1.14), history of injection drug use (OR = 18.24; 95% CI = 7.74-42.92), blood transfusion before 1991 (OR = 3.21; 95% CI = 1.02-10.12), and incarceration (OR = 3.48; 95% CI = 1.45-8.37). Among 5,066 students who denied injecting drugs, HCV prevalence was 0.8% in those who reported intranasal drug use and 0.6% each in those who reported tattoos and those who reported body piercing. Increased HBV prevalence was associated with high-risk sexual behaviors and black or Asian race. In conclusion, there was no increased risk for HCV or HBV infection in low-risk adults based solely on history of cosmetic procedures or snorting drugs. However, proper infection control practices for cosmetic procedures should be followed, illegal drug use discouraged, and hepatitis B vaccination provided to adolescents and sexually active adults.
authors.affiliation: Center for Infectious Diseases, Division of Epidemiology and Disease Control, University of Texas-Health Science Center at Houston, School of Public Health, Houston, TX 77030, USA. Lu-Yu.Hwang@uth.tmc.edu
authors.forename: Lu-Yu
authors.initials: LY
authors.lastname: Hwang
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Kramer
authors.forename: Catherine
authors.initials: C
authors.lastname: Troisi
authors.forename: Lara
authors.initials: L
authors.lastname: Bull
authors.forename: Carolyn Z
authors.initials: CZ
authors.lastname: Grimes
authors.forename: Rob
authors.initials: R
authors.lastname: Lyerla
authors.forename: Miriam J
authors.initials: MJ
authors.lastname: Alter
mesh_terms: D000293:Adolescent; D000328:Adult; D046289:Body Modification, Non-Therapeutic / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications*; D013781:Texas / Q000453:epidemiology