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Seroprevalence of Human Immunodeficiency Virus-1, Hepatitis B Virus, and Hepatitis C Virus in Patients Having Major Surgery

  • Marisa A. Montecalvo (a1), M. Sung Lee (a1), Helene DePalma (a2), Pe Shein Wynn (a3), Albert B. Lowenfels (a4), Ulrich Jorde (a1), David Wuest (a2), Arlene Klingaman (a5), Thomas A. O'Brien (a5), Mark Calmann (a5) and Gary P. Wormser (a1)...

Abstract

Objective:

To determine the proportion of major surgical procedures that involve patients having serologic evidence of infection with human immunodeficiency virus-1 (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) in a single center in Westchester County, New York.

Methods:

Blood samples sent for transfusion screening or cross-match were tested blindly for HIV antibody (anti-HIV), HBV core antibody, HBV surface antigen (HBsAg), and HCV antibody (anti-HCV). Demographic characteristics and operation category were correlated with serologic results by univariate and regression analyses.

Results:

Of 1,062 operations evaluated, 71 (6.7%, 95% confidence interval [CI95], 5.2% to 8.4%) were performed on patients with either anti-HIV, HBsAg, or anti-HCV. In 17 (1.6%, CI95, .93% to 2.5%) of these operations, the patient evidenced anti-HIV; in 15 (1.4%, CI95, .79% to 2.3%), HBsAg; and in 55 (5.2%, CI95, 3.9% to 6.7%), anti-HCV. Anti-HCV was detected significantly more often than anti-HIV (5.2% versus 1.6%, P<.001) or HBsAg (5.2% versus 1.4%, P<.001). Operations involving women aged 25 to 44 years had the highest proportion with serologic evidence of at least one of the three viruses (17.2%); of anti-HCV (15.3%); and of anti-HIV (6.7%). Logistic regression analysis found that being in the 25- to 44-year age group was associated significantly with infection with any virus (P<.001) and with anti-HCV (P<.001). The strongest logistic predictors of anti-HIV seropositivity were having anti-HCV seropositivity (P<.001), being age 25 to 44 years (P<.001), and having a general surgery operation (P=.002).

Conclusion:

The prevalences of serologic evidence of at least one of the three viruses (16.7%), of anti-HCV (14.5%), and of anti-HIV (5.6%) are high in patients aged 25 to 44 years undergoing major surgery at a tertiary-care medical center located in Westchester County, New York. Anti-HCV is more prevalent than anti-HIV or HBsAg and is predictive of anti-HIV seropositivity. Testing for anti-HIV alone would have detected only 24% of patients infected with a bloodborne pathogen. These data strongly underscore the importance of universal precautions.

Copyright

References

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1.Tokars, JI, Chamberland, ME, Schable, CA, et al.A survey of occupational blood contact and HIV infection among orthopedic surgeons. JAMA 1992;268:489494.
2.Tokars, JI, Bell, DM, Culver, DH, et al.Percutaneous injuries during surgical procedures. JAMA 1992;267:28992904.
3.Gerberding, JL, Littell, C, Tarkington, A, Brown, A, Schecter, WP. Risk of exposure of surgical personnel to patients' blood during surgery at San Francisco General Hospital. N Engl J Med 1990;322:17881793.
4.Panlilio, AL, Foy, DR, Edwards, JR, et al.Blood contacts during surgical procedures. JAMA 1991;265:15331537.
5.Panlilio, AL, Welch, BA, Bell, DM, et al.Blood and amniotic fluid contact sustained by obstetric personnel during deliveries. Am J Obstet Gynecol 1992;167:703708.
6.Panlilio, Al, Chamberland, ME, Shapiro, CN, et al.Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) serosur vey among hospital-based surgeons. J Am Coll Surg 1995;180:1624.
7.Lowenfels, AB, Wormser, GP, Jain, R. Frequency of puncture injuries in surgeons and estimated risk of HIV infection. Arch Surg 1989;124:3537.
8.Kelen, GD, Fitz, S, Qaqish, B, et al.Unrecognized human immunodefiency virus infection in emergency department patients. N Engl J Med 1988;318:16451650.
9.Marcus, R, Culver, DH, Bell, DM, et al.Risk of human immunodeficiency virus infection among emergency department workers. Am J Med 1993;94:363370.
10.St Louis, M, Rauch, KJ, Peterson, LR, et al.Seroprevalence rates of human immunodeficiency virus infection at sentinel hospitals in the United States. N Engl J Med 1990;323:213218.
11.Janssen, RS, St Louis, ME, Satten, GA, et al.HIV infection among patients in US acute-care hospitals. N Engl J Med 1992;327:445451.
12.Charache, P, Cameron, JL, Maters, A, Frantz, EI. Prevalence of infection with human immunodeficiency virus in elective surgery patients. Ann Surg 1991;214:562568.
13.Kelen, GD, Green, GB, Purcell, RH, et al.Hepatitis B and hepatitis C in emergency department patients. N Engl J Med 1992;326:13991404.
14.Handsfield, HH, Cummings, MJ, Swenson, PD. Prevalence of antibody to human immunodeficiency virus and hepatitis B surface antigen in blood samples submitted to a hospital laboratory. JAMA 1987;258:33953397.
15.Public Health Service. Protection against viral hepatitis. Recommendations of the immunization practices advisory committee. MMWR 1990;39:89.
16.Donahue, JG, Nelson, KE, Munoz, A, et al.Antibody to hepatitis C among cardiac surgery patients, homosexual men, and intravenous drug users in Baltimore, Maryland. Am J Epidemiol 1991;134:12061211.
17.Forseter, G, Wormser, GP, Adler, S, Lebovics, E, Calmann, M, O'Brien, TA. Hepatitis C in the health care setting, II: seroprevalence among hemodialysis staff and patients in suburban New York City. Am J Infect Control 1993;21:58.
18.Centers for Disease Control. Interpretation and use of the Western blot assay for serodiagnosis of human immunodeficiency virus type 1 infections. MMWR 1989;38:17.
19.Gardner, MJ, Altman, DG, eds. Statistics with confidence: confidence intervals and statistical guidelines. London, England: British Medical Journal; 1989.
20.Wormser, GP, Forseter, G, Joline, C, Tupper, B, O'Brien, T. Hepatitis C infection in the health care setting, I: low risk from parenteral exposure to blood of human immunodeficiency virus-infected patients. Am J Infect Control 1991;19:237242.
21.Kiyosawa, K, Sodeyama, T, Tanaka, E, et al.Hepatitis C in hospital employees with needlestick injuries. Ann Intern Med 1991;115:367369.
22.Mitsui, T, Iwano, K, Masuko, K. Hepatitis C infection in medical personnel after needlestick accident. Hepatology 1992;16:11091114.
23.Seeff, LB. Hepatitis C from a needlestick (letter). Ann Intern Med 1991;155:411.
24.Schlipkoter, U, Roggendorf, M, Cholmakow, K, Weise, A, Dienhardt, F. Transmission of hepatitis C virus from a hemodialysis patient to a medical staff member. Scand J Infect Dis 1990;22:757758.
25.Alter, MJ, Hadler, SC, Judson, FN, et al.Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C infection. JAMA 1990;264:22312235.
26.Cooper, BW, Krusell, A, Tilton, RC, Goodwin, R, Levitz, RE. Seroprevalence of antibodies to hepatitis C virus in high-risk hospital personnel. Infect Control Hosp Epidemiol 1992;13:8285.
27.Kane, MA, Alter, MJ, Hadler, SC, Margolis, HS. Hepatitis B infection in the United States. Am J Med 1989;87(suppl 3A):11S13S.
28.Lanphear, BP, Linnemann, CC, Cannon, CG, DeRonde, MM. Decline of clinical hepatitis B in workers at a general hospital: relation to increasing vaccine-induced immunity. Clin Infect Dis 1993;16:1014.
29.Centers for Disease Control and Prevention. Recommendations for prevention of HIV transmission in health care settings. MMWR 1987;36(suppl):3S18S.

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Seroprevalence of Human Immunodeficiency Virus-1, Hepatitis B Virus, and Hepatitis C Virus in Patients Having Major Surgery

  • Marisa A. Montecalvo (a1), M. Sung Lee (a1), Helene DePalma (a2), Pe Shein Wynn (a3), Albert B. Lowenfels (a4), Ulrich Jorde (a1), David Wuest (a2), Arlene Klingaman (a5), Thomas A. O'Brien (a5), Mark Calmann (a5) and Gary P. Wormser (a1)...

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