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The prevalence of hepatitis C in a regional level I trauma center population
A J Kaplan1, L K Zone-Smith, C Hannegan
1Department of Surgery, MUSC Medical Center, Charleston 29425.
Insights
Hepatitis C (HCV) affects 7.7% of trauma patients, a significant finding given its high chronicity. HIV and cocaine use were linked to higher HCV prevalence, underscoring the need for universal precautions.
Area of Science:
- Infectious Diseases
- Hepatology
- Trauma Surgery
Background:
- Hepatitis B (HBV) and human immunodeficiency virus (HIV) prevalence in trauma populations are documented.
- Hepatitis C virus (HCV) prevalence in this demographic remains largely unstudied.
- Trauma patients represent a unique population for infectious disease screening.
Purpose of the Study:
- To determine the prevalence of hepatitis C (HCV) in a regional level I trauma center.
- To assess the co-occurrence of HCV with hepatitis B (HBV), human immunodeficiency virus (HIV), and syphilis.
- To identify risk factors associated with HCV infection in trauma patients.
Main Methods:
- Prospective study of 286 consecutive adult trauma patients.
- Testing for anti-HCV antibodies using ELISA, and for HBV, HIV, and syphilis exposure.
- Data collected on illicit drug use, with statistical analysis using Yates' corrected chi 2 or Student's t test.
Main Results:
- HCV antibodies detected in 7.7% of patients (22/286).
- Prevalence of HBV (1.7%), HIV (3.2%), and syphilis (6%) also determined.
- HCV-positive patients showed higher rates of HIV (p=0.018) and cocaine use (p=0.0007).
Conclusions:
- HCV prevalence in trauma patients is substantial (7.7%), posing a risk due to high chronicity.
- HIV status and cocaine use are significant risk factors for HCV in this population.
- Universal precautions are critical due to the difficulty in eliciting risk factors in acute trauma settings.
Abstract:
Several studies have examined the prevalence of hepatitis B (HBV) and human immunodeficiency virus (HIV) in a trauma population. To our knowledge, no one has reported on the prevalence of hepatitis C (HCV). We prospectively studied the prevalence of HCV, as well as HBV, HIV, and syphilis in our adult regional level I trauma center population. Two hundred eighty-six consecutive trauma patients were tested for previous exposure to HCV using an anti-HCV mAb ELISA. Patients were also tested for exposure to HBV, HIV, and syphilis, and for illicit drug use. All rho values were calculated using Yates' corrected chi 2 or Student's t test. Twenty-two patients (7.7%) were found to have anti-HCV antibodies, five patients (1.7%) had active HBV, nine patients (3.2%) had HIV, and 16 patients (6%) were positive by RPR. Four (18%) of the patients seropositive for HCV tested positive for HBV, HIV, or syphilis as well. The HIV-positive patients were more likely than the HIV-negative patients to be HCV positive (rho = 0.018). Nine of the HCV seropositive patients (41%) tested positive for cocaine use. Cocaine users were more likely than nonusers to be HCV positive (rho = 0.0007). We have demonstrated the prevalence of HCV in our trauma population to be high (7.7%). It is well known that HCV has a high rate of chronicity, thus up to 90% of these patients are carriers and represent a substantial risk to health care workers. The two significant risk factors, HIV status and cocaine use, are difficult to elicit in the acute setting, reinforcing the need for adhering to universal precautions.