title: Tattooing and the risk of transmission of hepatitis C: a systematic review and meta-analysis.
abstract: OBJECTIVE
  In this systematic literature review we sought to determine whether tattooing is a risk factor for the transmission of hepatitis C.
  
  
  METHODS
  A comprehensive search was performed to identify all case-control, cohort or cross sectional studies published prior to November 2008 that evaluated risks related to tattooing or risk factors of transmission of hepatitis C infection.
  
  
  RESULTS
  A total of 124 studies were included in this systematic review, of which 83 were included in the meta-analysis. The pooled odds ratio (OR) and 95% confidence interval (CI) of the association of tattooing and hepatitis C from all studies was 2.74 (2.38-3.15). In a subgroup analysis we found the strongest association between tattooing and risk of hepatitis C for samples derived from non-injection drug users (OR 5.74, 95% CI 1.98-16.66).
  
  
  CONCLUSIONS
  Findings from the current meta-analysis indicate that tattooing is associated with a higher risk of hepatitis C infection. Because tattooing is more common among the youth and young adults and hepatitis C is very common in the imprisoned population, prevention programs must focus on youngsters and prisoners to lower the spread of hepatitis infection.
authors.affiliation: Community Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Siavash
authors.initials: S
authors.lastname: Jafari
authors.forename: Ray
authors.initials: R
authors.lastname: Copes
authors.forename: Souzan
authors.initials: S
authors.lastname: Baharlou
authors.forename: Mahyar
authors.initials: M
authors.lastname: Etminan
authors.forename: Jane
authors.initials: J
authors.lastname: Buxton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016021:Epidemiologic Studies; D016174:Hepacivirus / Q000472:pathogenicity*; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology* / Q000635:transmission*; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D013653:Tattooing / Q000009:adverse effects*; D055815:Young Adult