- Category: HCV Prevention
- Published on Tuesday, 29 January 2013 00:00
- Written by Liz Highleyman
Individuals with chronic hepatitis C virus (HCV) infection in New York City were about 5 times more likely to have a tattoo than people without HCV, even after traditional risk factors such as injection drug use were taken into account, researchers reported in the January 12, 2013, advance online edition of Hepatology.
HCV is transmitted easily via blood-to-blood contact, as can occur when people share syringes for injecting drugs, when medical equipment is not properly sterilized, and potentially when tools for tattooing or piercing are used without adequate precautions. Injection drug use is the most common risk factor, but approximately 20% of the more than 3 million people with HCV in the U.S. do not know how they became infected.
Kerrilynn Carney and Fritz Francois from New York University's Langone Medical Center and colleagues conducted a large case-control study to analyze demographic and HCV exposure data from 1930 people with chronic hepatitis C and 1941 matched HCV antibody negative control subjects seen at outpatient clinics in New York City between 2004 and 2006.
- As expected, traditional exposure risk factors were reported significantly more often by people with HCV compared with uninfected participants:
o Injection drug use: 65.9% vs 17.8%, respectively;
o Blood transfusion prior to 1992 (when HCV screening was adopted): 22.3% vs 11.1%, respectively.
- In addition, people with HCV were also more likely to have 1 or more tattoos than uninfected people (odds ratio 3.81, or nearly 4-fold higher likelihood).
- After excluding participants with any reported history of injection drug use or blood transfusions before 1992, there were 465 remaining HCV positive people and 1421 uninfected control subjects.
- In a multivariate analysis of these individuals without traditional risk factors, people with HCV were still significantly more likely to have tattoos than uninfected people after adjusting for age, sex, and race/ethnicity (OR 5.17, or more than 5 times greater likelihood).
Based on these findings, the study authors concluded, "Tattooing is associated with HCV infection, even among those without traditional HCV risk factors such as injection drug use and blood transfusion prior to 1992."
This analysis looked at overall frequency of tattoos, but not all tattoos are created equal. Work done by professional artists under sanitary conditions -- including new needles and ink pots for each client and proper cleaning of tattoo guns and other equipment -- is much less likely to result in HCV transmission than amateur tattoos using shared needles, as sometimes occurs in prison and other non-professional settings.
A recent meta-analysis found that 6 out of 10 case-control studies -- unlike the current analysis -- showed no increased risk of HCV infection associated with tattooing after controlling for injection drug use and other traditional risk behaviors. Among studies that specified a venue, there was no evidence for an increased risk of HCV infection when tattoos were done in professional parlors. However, the risk of HCV infection was significantly higher when tattoos were done in prison or by non-professional friends.
K Carney, S Dhalla, A Aytaman, et al. Association of tattooing and hepatitis C virus infection: A multicenter case-control study. Hepatology. January 12, 2013 (Epub ahead of print).