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Seroprevalence of Human Immunodeficiency Virus-1, Hepatitis B Virus, and Hepatitis C Virus in Patients Having Major Surgery

Marisa A. Montecalvo, M. Sung Lee, Helene DePalma, Pe Shein Wynn, Albert B. Lowenfels, Ulrich Jorde, David Wuest, Arlene Klingaman, Thomas A. O'Brien, Mark Calmann and Gary P. Wormser
Infection Control and Hospital Epidemiology
Vol. 16, No. 11 (Nov., 1995), pp. 627-632
DOI: 10.2307/30141113
Stable URL: http://www.jstor.org/stable/30141113
Page Count: 6
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Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
Seroprevalence of Human Immunodeficiency Virus-1, Hepatitis B Virus, and Hepatitis C Virus in Patients Having Major Surgery
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Abstract

Objective: To determine the proportion of major surgical procedures that involve patients having serologic evidence of infection with human immunodeficiency virus-1 (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) in a single center in Westchester County, New York. Methods: Blood samples sent for transfusion screening or cross-match were tested blindly for HIV antibody (anti-HIV), HBV core antibody, HBV surface antigen (HBsAg), and HCV antibody (anti-HCV). Demographic characteristics and operation category were correlated with serologic results by univariate and regression analyses. Results: Of 1,062 operations evaluated, 71 (6.7%, 95% confidence interval [$CI_{95}$], 5.2% to 8.4%) were performed on patients with either anti-HIV, HBsAg, or antiHCV. In 17 (1.6%, $CI_{95}$, .93% to 2.5%) of these operations, the patient evidenced anti-HIV; in 15 (1.4%, $CI_{95}$, .79% to 2.3%), HBsAg; and in 55 (5.2%, $CI_{95}$, 3.9% to 6.7%), anti-HCV. AntiHCV was detected significantly more often than anti-HIV (5.2% versus 1.6%, P<.001) or HBsAg (5.2% versus 1.4%, P<.001). Operations involving women aged 25 to 44 years had the highest proportion with serologic evidence of at least one of the three viruses (17.2%); of anti-HCV (15.3%); and of anti-HIV (6.7%). Logistic regression analysis found that being in the 25- to 44-year age group was associated significantly with infection with any virus (P<.001) and with anti-HCV (P<.001). The strongest logistic predictors of antiHIV seropositivity were having anti-HCV seropositivity (P<.001), being age 25 to 44 years (P<.001), and having a general surgery operation (P=.002). Conclusion: The prevalences of serologic evidence of at least one of the three viruses (16.7%), of antiHCV (14.5%), and of anti-HIV (5.6%) are high in patients aged 25 to 44 years undergoing major surgery at a tertiarycare medical center located in Westchester County, New York. Anti-HCV is more prevalent than anti-HIV or HBsAg and is predictive of anti-HIV seropositivity. Testing for anti-HIV alone would have detected only 24% of patients infected with a bloodborne pathogen. These data strongly underscore the importance of universal precautions.

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