FREQUENCY OF HEPATITIS B AND C IN PATIENTS UNDERGOING ELECTIVE SURGERY
Abstract
Background: Viral Hepatitis (HBV and HCV) is a major health problem affecting approximatelytwo billion population worldwide. It is one of the single most important cause of chronic liver
disease and hepato-cellular carcinoma in Pakistan and worldwide and is now spreading beyond
endemic dimensions. This study was carried out to assess the frequency of Hepatitis B and C
infection in patients undergoing elective surgical operations, and to evaluate the associated risk
factors. Methods: This was a descriptive study, conducted at Surgical Department of Ghulam
Muhammad Mahar Medical College Hospital, Sukkur, from April 2009 to March 2010. All patients
who were admitted in the Surgical Department for elective surgical operations were included in the
study. The patients were screened for HBsAg and Anti-HCV using immunochromatography (ICT)
method. Those who were weak positive by ICT were further confirmed by ELISA. Results: Total
913 patients were admitted in Surgical Department during study period for elective operations and
were screened for HBsAg and Anti-HCV. Out of these, 572 (62.65%) were male and 341 (37.34%)
were female. Mean age of these patients was 40 years. After screening, 33 (3.61%) patients were
found HBsAg positive and 117 (12.8%) were Anti-HCV positive, while 9 (0.98%) were positive for
both. Hepatitis-B was found in 21 (2.3%) males and 12 (1.3%) females, and Hepatitis-C was found
in 68 (7.44%) males and 49 (5.36%) female patients. Parenteral injections by quacks, previous
surgery, blood transfusion and shaving by barbers were found to be the risk factors. Conclusion: Our
message is: '˜Prevention is better than cure'. It is essential to prevent spread of Hepatitis B and C by
screening every patient before surgery and counselling the patients. The doctors and paramedical
staff must follow proper ethical practice ensuring use of sterile disposables where indicated and
protecting patients and themselves from these viral infections.
Keywords: Hepatitis-B, Hepatitis-C, Screening, Surgical patients
References
Cusheri A. Acute and chronic hepatitis. In: Cusheri A, Steele JC,
Moosa AR. (Eds) Essential surgical practice. 5th Edition. Oxford
University Press; 2002. p.334-5.
EASL Jury. EASL International Consensus Conference on
Hepatitis B. 13-14 September 2002 Geneva, Switzerland. J
Hepatol 2003;38:533-40.
Khokhar N, Gill ML, Malik GL. General seroprevalance of
Hepatitis B and C infection in the population. J Coll Physicians
Surg Pak 2004;14:534-6.
Tanwani K, Ahmad N, Prevalence of Hepatitis B surface antigen
and anti-Hepatitis C virus in laboratory based at Islamabad. J
Surg 2000;19-20:25-9.
Supsa VE, Hadjipashali E, Hatzakis A. Prevalence of risk factors
and evaluation of a screening strategy for Hepatitis B and C viral
infections in healthy company employees. Euro J Epidemiol
;17:721-8.
Shah HN, Shabbir G. A review of published literature on
Hepatitis B and C virus prevalence in Pakistan. J Coll Physicians
Surg Pak 2002;12:368-71.
Sara H, Cody MD, Omana V, Meyers H, Bell BP, Shapiro CN, et
al. Hepatitis C virus transmission from an Anesthesiologist to a
patient. Arch Intern Med 2002;162:345-50.
Cardell K, Widell A, Frydén A, Akerlind B, Månsson AS,
Franzén S, et al. Nosocomial hepatitis C in a thoracic surgery
unit; retrospective findings generating a prospective study. J
Hosp Infect 2008;68:322-8.
Zubia M, Masood J, Khan RA, Shafiq ur Rehman. Screening for
Hepatitis B and C: a routine preoperative investigation? Pak J
Med Sci 2005;21:455-9.
Chaudry IA, Khan SS, Majrooh MA, Alvi AA. Seroprevalence
of hepatitis B and C among the patients reporting at surgical OPD
at fauji foundation Hospial Rawalpindi. Pak J Med Sci
;23:514-17.
Talpur AA, Ansari AG, Awan MS, Ghumro AA, Prevalence of
hepatitis B and C in surgical patients. Pak J Surg
:22(3):150-3.
Daudpota AQ, Soomro AW. Seroprevalence of hepatitis B and C
in surgical patients. Pak Med Sci 2008;24:483-4.
Taguchi S, Nishioka K, Kawaguchi R, Nakao Mankaom,
Watanabe I, Migita T. Epidemiological study of hepatitis B and
C in 34336 patients operated at Hiroshima Prefectual Hospital
during the period from 1993 to 2000. Masui 2004;53:696-700.
Yanaga K, Wakiyama S, Soejimay, Yoshizumi T, Nishizaki
T, Sugimachi K. Hepatitis C virus infection among Japanese
general surgical patients. World J Surg 1995;19:694-7.
Chaudhary IA, Khan SA, Samiullah. Should we do the hepatitis
B and C screening on each patient before surgery. Pak J Med Sci
;21:278-80.
Ali SA, Shaikh FA, Ahmed K. Prevalence of hepatitis B and C
virus in surgical patients. Pak J Surg 2007;23:109-12.
Weis ES, Makary MA, Wang T, Syin D, Pronovost PJ,
Chang D, et al. Prevalence of blood-borne pathogens in an
urban, university-based general surgical practice. Ann Surg
;241:803-7.
Meri Koulentaki, Maria Ergazaki, Joanna Moschandrea, Stelios
Spanoudakis, Nikolaos Tzagarakis. Prevalence of hepatitis B
and C workers in high-risk hospitalised patients in Grete. A
five-year observational study. BMC Public Health, 2001;1:17.
Khokhar N, Gill ML, Yawar A. Interspousal transmission of
Hepatitis C virus. J Coll Physicians Surg Pak 2005;15:587-9.
De Carli G, Puro V, Ippolito G; Studio Italiano Rischio
Occupazionale da HIV Group. Risk of hepatitis C virus
transmission following percutaneous exposure in healthcare
workers. Infection 2003;31(Suppl 2):22-7.
Moosa FA, Shaikh BA, Choudhry MS, Zuberi BF, Khan FW,
Sultan N. Frequency of hepatitis B and C in preoperative patients
for elective surgery. J Liaquat Uni Med Health Sci
;8(2):150-2.
J Ayub Med Coll Abbottabad 2010;22(2)
http://www.ayubmed.edu.pk/JAMC/PAST/22-2/Rafique.pdf
Bialek SR, Bower WA, Mottram K, Purchase D, Nakano
T, Nainan O, et al. Risk factors for Hepatitis B in an outbreak of
hepatitis B and D among injection drug users. J Urban Health
;82:468-78.
Yazdanpanah Y, De Carli G, Migueres B, Lot F, Campins
M, Colombo C, et al. Risk factors for hepatitis C virus
transmission to healthcare workers after occupational
exposure: A European case-control study. Clin Infect Dis
;41:1423-30.
Cholongitas E, Senzolo M, Patch D, Kwong K, Nikolopoulou
V, Leandro G, et al. Risk factors, sequential organ failure
assessment and model for end-stage liver disease scores for
predicting short term mortality in cirrhotic patients admitted to
intensive care unit. Aliment Pharmacol Ther 2006;23:883-93.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.