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

Published online by Cambridge University Press:  02 January 2015

Marisa A. Montecalvo
Affiliation:
Division of Infectious Diseases and the Department of Medicine, Valhalla, New York
M. Sung Lee
Affiliation:
Division of Infectious Diseases and the Department of Medicine, Valhalla, New York
Helene DePalma
Affiliation:
Hudson Valley Blood Services, Valhalla, New York
Pe Shein Wynn
Affiliation:
Department of Community and Preventive Medicine, Valhalla, New York
Albert B. Lowenfels
Affiliation:
Department of Surgery, New York Medical College, Valhalla, New York
Ulrich Jorde
Affiliation:
Division of Infectious Diseases and the Department of Medicine, Valhalla, New York
David Wuest
Affiliation:
Hudson Valley Blood Services, Valhalla, New York
Arlene Klingaman
Affiliation:
Ortho Diagnostic Systems Inc, Raritan, New Jersey
Thomas A. O'Brien
Affiliation:
Ortho Diagnostic Systems Inc, Raritan, New Jersey
Mark Calmann
Affiliation:
Ortho Diagnostic Systems Inc, Raritan, New Jersey
Gary P. Wormser
Affiliation:
Division of Infectious Diseases and the Department of Medicine, Valhalla, New York

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.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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References

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.CrossRefGoogle ScholarPubMed
2.Tokars, JI, Bell, DM, Culver, DH, et al.Percutaneous injuries during surgical procedures. JAMA 1992;267:28992904.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
4.Panlilio, AL, Foy, DR, Edwards, JR, et al.Blood contacts during surgical procedures. JAMA 1991;265:15331537.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
7.Lowenfels, AB, Wormser, GP, Jain, R. Frequency of puncture injuries in surgeons and estimated risk of HIV infection. Arch Surg 1989;124:3537.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
15.Public Health Service. Protection against viral hepatitis. Recommendations of the immunization practices advisory committee. MMWR 1990;39:89.Google ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google ScholarPubMed
19.Gardner, MJ, Altman, DG, eds. Statistics with confidence: confidence intervals and statistical guidelines. London, England: British Medical Journal; 1989.Google Scholar
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.CrossRefGoogle ScholarPubMed
21.Kiyosawa, K, Sodeyama, T, Tanaka, E, et al.Hepatitis C in hospital employees with needlestick injuries. Ann Intern Med 1991;115:367369.CrossRefGoogle ScholarPubMed
22.Mitsui, T, Iwano, K, Masuko, K. Hepatitis C infection in medical personnel after needlestick accident. Hepatology 1992;16:11091114.CrossRefGoogle ScholarPubMed
23.Seeff, LB. Hepatitis C from a needlestick (letter). Ann Intern Med 1991;155:411.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
27.Kane, MA, Alter, MJ, Hadler, SC, Margolis, HS. Hepatitis B infection in the United States. Am J Med 1989;87(suppl 3A):11S13S.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
29.Centers for Disease Control and Prevention. Recommendations for prevention of HIV transmission in health care settings. MMWR 1987;36(suppl):3S18S.Google ScholarPubMed
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