Risk of parenterally transmitted hepatitis following exposure to surgery or other invasive procedures: results from the hepatitis surveillance system in Italy

J Hepatol. 2001 Aug;35(2):284-9. doi: 10.1016/s0168-8278(01)00111-8.


Background/aims: To evaluate the strength of association between parenterally transmitted viral hepatitis and specific types of invasive procedures.

Methods: Data from the surveillance system for type-specific acute viral hepatitis (SEIEVA) during the period 1994-1999 were used. The association of acute hepatitis B virus (HBV) and hepatitis C virus (HCV) infection with the potential risk factors (odds ratios (OR)) was estimated comparing 3120 hepatitis B and 1023 hepatitis C cases with 7158 hepatitis A cases, used as controls, by multiple logistic regression analysis.

Results: Most procedures resulted in being associated with the risk of acquiring acute HBV or HCV. The strongest associations were: for HBV infection, abdominal surgery (adjusted OR = 3.9; 95% confidence intervals (CI) = 2.0-7.5), oral surgery (OR = 2.7; 95% CI = 1.6-4.5) and gynaecological surgery (OR = 2.6; 95% CI = 1.2-5.5); for HCV infection, obstetric/gynaecological interventions (OR = 12.1; 95% CI = 5.6-26.3), abdominal surgery (OR = 7.0; 95% CI = 3.2-14.9) and ophthalmological surgery (OR = 5.2; 95% CI = 1.1-23.2). Biopsy and/or endoscopy were associated with HCV, but not with HBV infection.

Conclusions: Invasive procedures represent an important mode of HBV and HCV transmission. Since a large proportion of the adult general population is exposed to these procedures and an effective HCV vaccine is not yet available, non-immunological means of controlling iatrogenic modes of transmission are extremely important.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Hepatitis A / etiology*
  • Hepatitis A / transmission*
  • Hepatitis B / etiology*
  • Hepatitis B / transmission*
  • Hepatitis C / etiology*
  • Hepatitis C / transmission*
  • Humans
  • Iatrogenic Disease
  • Italy
  • Male
  • Middle Aged
  • Odds Ratio
  • Postoperative Complications / etiology
  • Regression Analysis
  • Risk Factors
  • Surgical Procedures, Operative / adverse effects