The prevalence of hepatitis C among healthcare workers: a systematic review and meta-analysis

Abstract

The aim of this study was to estimate the prevalence of viral hepatitis C (HCV) infection among healthcare workers (HCWs) compared to the general population. A systematic search for the years 1989–2014 was conducted in the Medline, Embase and Cochrane databases. Studies on hepatitis C in HCWs were included if they incorporated either a control group or reference data for the general population. The study quality was classified as high, moderate or low. Pooled effect estimates were calculated to determine the odds of occupational infection. Heterogeneity between studies was analysed using the χ2 test (p<0.10) and quantified using the I2 test. 57 studies met our criteria for inclusion and 44 were included in the meta-analysis. Analysis of high and moderate quality studies showed a significantly increased OR for HCV infection in HCWs relative to control populations, with a value of 1.6 (95% CI 1.03 to 2.42). Stratification by study region gave an OR of 2.1 in low prevalence countries; while stratification by occupational groups gave an increased prevalence for medical (OR 2.2) and for laboratory staff (OR 2.2). The OR for professionals at high risk of blood contact was 2.7. The pooled analysis indicates that the prevalence of infection is significantly higher in HCWs than in the general population. The highest prevalence was observed among medical and laboratory staff. Prospective studies that focus on HCW-specific activity and personal risk factors for HCV infection are needed.

Hepatitis C in Canada and the importance of risk-based screening

“…In addition, a recent systematic review of international publications reported that health care workers in direct contact with patients or blood (from needle stick injuries) are 1.6 times more likely to be infected with HCV than the general population. Increased prevalence of HCV was found among medical staff (OR 2.2), laboratory staff (OR 2.2) and dental staff (OR 3.5) compared to controls (27). HCV outbreaks have also occurred in colonoscopy clinics in Canada (31-35).…”

“…in hospitals, dental offices) or personal service (e.g. tattoo parlours and nail salons) is another risk for HCV infection (26)(27)(28)(29)(30). For instance, patients undergoing hemodialysis are at increased risk of acquiring HCV, especially if the equipment has been reused or improperly sterilized (26).…”

Acute Hepatitis C Virus Infection and Directly Acting Anti-Hepatitis C Virus Drugs

“…In a recent meta-analysis, the reported AHC estimates among health care workers (HCW) from 1989 to 2014 had exceeded 200% higher prevalence than the public [10]. Furthermost, the situation is more critical in developing countries e.g.…”

“…Furthermost, the situation is more critical in developing countries e.g. Egypt, and Nigeria, which are cursed by the triad of poverty, illiteracy, and of course disease [10]. Needle stick injuries are verified as the most deleterious risk accidents among HCW with an average rate of HCV infection of 0.5% [10].…”

“…Egypt, and Nigeria, which are cursed by the triad of poverty, illiteracy, and of course disease [10]. Needle stick injuries are verified as the most deleterious risk accidents among HCW with an average rate of HCV infection of 0.5% [10]. Unfortunately, the lack of adequate reporting and surveillance data are pivotally responsible for the erroneous AHC estimates.…”