Tattooing and the risk of transmission of hepatitis C: a systematic review and meta-analysis.

Summary Objectives In this systematic literature review we sought to determine whether tattooing is a risk factor for the transmission of hepatitis C. Methods A comprehensive search was performed to identify all case-control, cohort or cross sectional studies published prior to November 2008 that evaluated risks related to tattooing or risk factors of transmission of hepatitis C infection. Results A total of 124 studies were included in this systematic review, of which 83 were included in the meta-analysis. The pooled odds ratio (OR) and 95% confidence interval (CI) of the association of tattooing and hepatitis C from all studies was 2.74 (2.38–3.15). In a subgroup analysis we found the strongest association between tattooing and risk of hepatitis C for samples derived from non-injection drug users (OR 5.74, 95% CI 1.98–16.66). Conclusions Findings from the current meta-analysis indicate that tattooing is associated with a higher risk of hepatitis C infection. Because tattooing is more common among the youth and young adults and hepatitis C is very common in the imprisoned population, prevention programs must focus on youngsters and prisoners to lower the spread of hepatitis infection.