Tattooing and risk of hepatitis B: a systematic review and meta-analysis.
OBJECTIVE
The objective of this systematic review and meta-analysis is to assess the association between tattooing and the risk of transmission of hepatitis B virus.


METHODS
A systematic search of MEDLINE, EMBASE, PubMed, Database of Abstracts of Reviews of Effects, ACP Journal Club and BIOSIS Previews was performed up to March 2011.


RESULTS
Forty-two observational studies were included in this systematic review, of which 31 were included in the meta-analysis. Pooled odds ratios (95% confidence intervals) of the association of tattooing and hepatitis B infection was 1.48 (1.30-1.68) when all studies were included in the analysis. Subgroup analysis shows the strongest association between tattooing and risk of hepatitis B among populations involved in high-risk behaviours (OR = 1.64, 95% CI: 1.32-2.03).


CONCLUSIONS
Findings of the current systematic review and meta-analysis indicate that tattooing is associated with hepatitis B transmission in all subgroups. A population health approach that emphasizes universal hepatitis B immunization, education of young adults who are more likely to get tattoos, and education of prison inmates (who have the highest background rate of hepatitis B infection), along with enforcement of guidelines and safer tattooing practices in prison, are fundamental in prevention of transmission of hepatitis B.
School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC.
Siavash
S
Jafari
Jane A
JA
Buxton
Kourosh
K
Afshar
Ray
R
Copes
Souzan
S
Baharlou
D006509:Hepatitis B / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D012307:Risk Factors; D013653:Tattooing / Q000009:adverse effects*