[Rationale for the implementation of pre-operative testing for HCV in the light of anti-HCV and HBsAG tests results in surgical patients from a teaching hospital].
Many Polish hospitals compel patients admitted for elective surgery to be immunised for HBV; testing for HBsAg is recommended before. We surveyed immunisation coverage for HBV and prevalence of HBsAg and anti-HCV among surgical patients to assess existing pre-operative screening policies.


METHODS
questionnaire data and sera were collected anonymously from 400 consecutive adults admitted to 4 surgical wards of a teaching hospital in Szczecin, Poland during October 2006/December 2007. Samples were assayed for HBsAg, and anti-HCV.


RESULTS
Serologic evidence for either HBsAg or anti-HCV was 2.3% (9/400; 95% CI: 1.2-4.2%), all in elective cases; 1.5% (6/400; 95% CI: 0.7-3.2%) were positive for anti-HCV, 0.75% (3/400; 95% CI: 0.26-2.18%) for HBsAg. None of anti-HCV positive patients was aware of their infection, as well as 1 in 3 HBsAg carriers. Anti-HCV and HBsAg prevalence in 20131 blood donors which served as controls were 0.08% (95% CI: 0.02-0.15%) and 0.11% (95% CI: 0.04-0.2%) respectively. HBV immunisation coverage was 247/398 (62%), higher (p < 0.0001) in those undergoing elective rather than emergency surgery.


CONCLUSIONS
anti-HCV prevalence was double that for HBsAg. These data give evidence for the expansion of the existing screening programme for blood borne infections among elective surgical patients, to also cover those infected with HCV. A third of patients were unimmunised, remaining a potential pool for HBsAg carriers.
Gańczak
Maria
M
Zakad Higieny, Epidemiologii i Zdrowia Publicznego, Pomorska Akademia Medyczna. mganczak@sci.pam.szczecin.pl
Szych
Zbigniew
Z
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D018937:Hepatitis C Antibodies / Q000097:blood*; D018936:Hepatitis C Antigens / Q000097:blood*; D006784:Hospitals, Teaching; D006801:Humans; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011300:Preoperative Care; D016036:Seroepidemiologic Studies; D012698:Serologic Tests; D055815:Young Adult
D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D018936:Hepatitis C Antigens