The risk of hepatitis C virus (HCV) infection is significantly associated with various invasive procedures and in-hospital examinations. This is apparent from a systematic review with meta-analysis recently published in Alimentary Pharmacology Therapeutics.
The aim of the researchers was to better understand and quantify the role of invasive hospital treatments in HCV transmission. They searched the literature databases of PubMed, Web of Science and Scopus for studies published between 2000 and 2020 that reported measures for the association between HCV infection risk and iatrogenic procedures.
They found 71 relevant studies in which blood transfusion (66 measurements) and surgery (43 measurements) were studied most often. Based on expert opinion, procedures were divided into 10 categories for which separate, pooled odds ratios (ORs) were calculated. Subsequently, relationships between the pooled measures and country-level HCV prevalence or the Healthcare Access and Quality (HAQ) index were meta-regressed.
The pooled ORs for HCV infection ranged from 1.46 (95% CI 1.14-1.88) for dental procedures to 3.22 (95% CI 1.7-6.11) for transplants. For blood transfusions, the risk was higher for transfusions performed before 1998 (3.77; 95% CI 2.42-5.88) than for transfusions performed more recently (2.20; 95% CI 1.77-2.75) . In the subgroup analysis for the specific hospital treatments, the HAQ index for endoscopy was found to be negatively associated with HCV infection risk, while the risk of infection was positively associated with HCV prevalence for endoscopy and surgery.
Finally, in the article, the researchers provide a ranking for the HCV risk of various interventions and studies that can be used to prioritize infection prevention interventions. This ranking is particularly relevant with a high HCV prevalence.
Henriot P, Castry M, Luong Nguyen LB, Shimakawa Y, Jean K, Temome L. Meta-analysis: risk of hepatitis C virus infection associated with hospital-based invasive procedures. Aliment Pharmacol Ther. 2022;56:558-69.