Newly diagnosed hepatitis-B and hepatitis-C during surgical pre-operative assessment of patients from lower socioeconomic class; frequency,risk factors and vaccination status

Objective: to see the frequency of newly diagnosed hepatitis-b and hepatitis-c cases during pre-operative surgical assessment of patients from lower socioeconomic class and to study the possible risk factors. study design: descriptive cross sectional study. setting: department of surgery,sir syed college of medical sciences and hospital,karachi. study duration: from july 2012 to july2013. material and methods: total 107 patients (≥18 years)of both genders from lower socioeconomic class planned for elective surgical procedure were included after ethical approval. previously diagnosed cases of hepatitis-b and c were excluded. after history and clinical examination,hepatitis-b &hepatitis-c serology was performed (eliza technique). history of blood transfusion,previous dental or surgical procedures,intravenous injections,intravenous drug abuse,tattooing,piercing,circumcision,shaving by barbers,unprotected sex and hepatitis-b vaccination status obtained. data was analyzed by spss version 17. results: among 107 cases (42% males & 58% females) with mean age 39±14 years,hepatitis- b infection was present in 6(6%) cases,hepatitis-c in 11(10%) and hepatitis-b and c serology was negative in 90 (84%) cases. frequency of hepatitis-b was 3% (in males) versus 9% (in females); hepatitis-c 6.4% (in males) versus 15.5% (in females). among those with hepatitis-b or c,history of previous surgical procedure present in 47% cases (vs. 21% in hepatitis-b and c negative cases),dental procedure in 29.4% (vs. 7.7 %),intravenous injections in 94% (vs. 43%),intravenous drug abuse in 5.8% (vs. 0 %),blood transfusion in 35% (vs. 12%),tattooing in 0% (vs. 2%),unprotected sex in 5.8% (vs. 1%),piercing in 64.7% (vs. 39%),circumcision by barbers in 83.3%of males (vs. 80%),shaving by barbers in 66.6% of males (vs. 27%). hepatitis-b and c was found to be associated with history of blood transfusion,intravenous injections,dental procedures,shaving by barbers,piercing and intravenous drug abuse (p<0.05). clinical stigmata of liver disease were present in 3% cases. among all cases 9% were previously vaccinated for hepatitis-b. conclusion: preoperative determination of hepatitis viral markers is a good clinical practice to limit transmission from asymptomatic carriers and to diagnose new cases. pakistan has high prevalence of hepatitis-b and c and poverty and low literacy rate are the main determinants of its spread. those who are negative for hepatitis-b should be encouraged to get vaccinated. there is need for measures to create awareness about preventive measures and affective control of transmission of hepatitis-b and c in community as well as at health care facilities. © 2014,liaquat university of medical and health sciences. all rights reserved.