Relationship of cosmetic procedures and drug use to hepatitis C and hepatitis B virus infections in a low-risk population

Abstract

We conducted an anonymous cross-sectional seroprevalence study of a population with a low frequency of injection drug use to determine whether persons with a history of cosmetic procedures, such as tattooing and body piercing, or intranasal drug use were at increased risk for hepatitis C virus (HCV) or hepatitis B virus (HBV) infection. Students 18 years and older from eight college campuses in Houston, Texas, were invited to participate in the study. Of the 7,960 who completed a self-administered questionnaire and provided a blood sample, 5,282 U.S.-or Canadian-born participants were analyzed. Their median age was 21, 62% were female, 42% were white, 26% black, 22% Hispanic, and 10% Asian or other. Two percent reported injection drug use, 13.7% intranasal drug use, 21.2% body piercings, and 25.2% tattoos. The overall prevalence of HCV infection was 0.9% and of HBV infection was 5.2%. Higher HCV prevalence was independently associated with increasing age (odds ratio [OR] per year ‫؍‬ 1.11; 95% confidence interval [CI] ‫؍‬ 1.08-1.14), history of injection drug use (OR ‫؍‬ 18.24; 95% CI ‫؍‬ 7.74-42.92), blood transfusion before 1991 (OR ‫؍‬ 3.21; 95% CI ‫؍‬ 1.02-10.12), and incarceration (OR ‫؍‬ 3.48; 95% CI ‫؍‬ 1.45-8.37). Among 5,066 students who denied injecting drugs, HCV prevalence was 0.8% in those who reported intranasal drug use and 0.6% each in those who reported tattoos and those who reported body piercing. Increased HBV prevalence was associated with high-risk sexual behaviors and black or Asian race. In conclusion, there was no increased risk for HCV or HBV infection in low-risk adults based solely on history of cosmetic procedures or snorting drugs. However, proper infection control practices for cosmetic procedures should be followed, illegal drug use discouraged, and hepatitis B vaccination provided to adolescents and sexually active adults. (HEPATOLOGY 2006;44:341-351.)

PHS Guideline for Reducing Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Transmission through Organ Transplantation

“…126 One study also considered steroid injection but did not find a significant relationship between injection steroid use and HBV infection. 122 The evidence of prevalence of IDU, reported in the general population study as 3.5%, 123 was rated low quality.…”

“…122 Piercings within the last six months were also not associated with acute HBV in the general population. 127 13. International travel.…”

“…Two of five studies found an association with HBV and non-injection illicit drugs. 118,121,122,124,125 An NHANES study of the general population found any prior cocaine use was associated with HBV in a multivariate analysis, but this study did not control for 122 unless the college students were tattooed with reused non-autoclaved needles. Having a tattoo in the last six months was not associated with acute HBV infection.…”

“…Moderate-quality evidence from two studies was found suggesting hemodialysis as a risk factor for HBV (Appendix D). Studies using univariate analyses found that hemodialysis was associated with HBV infection among participants in a general population study 123 and college students 122 with large effect sizes.…”

“…121 Age #15 years at first intercourse was associated with HBV infection among college students. 122 10. Additional various (sexual) associations.…”