Antibodies to hepatitis C virus: a cross-sectional study in patients attending a trauma unit or admitted to hospital for elective surgery.

Objective : To assess the prevalence of hepatitis C virus (HCV) antibodies in patients attending a trauma unit or admitted to hospital for elective surgery, and to identify risk factors for acquiring HCV infection. Design : A cross-sectional study. Setting : The emergency room of a Department of Orthopaedic Surgery and a hospital for elective (non-digestive) surgery. Patients : A study population of 1824 subjects (mean age 40.1±18.1 years) and sera from a control group of 4703 blood donors giving their first donation. Interventions : Serum samples were screened for HCV antibodies by second-generation enzyme-linked immunosorbent assays and recombinant immunoblot assays. Main outcome measures : HCV serostatus and the relationship between anti-HCV-positivity and age, intravenous drug use, tattoos, blood transfusion, a history of hepatitis and exposure to a contact who had had hepatitis. Results : The overall prevalence of anti-HCV antibodies was 2.85% in the study population and 0.5% among blood donors (X 2 =64.5 ; P<0.0001). Anti-HCV-positivity was more common in men (3.8 versus 1.9% ; P<0.05) and in subjects with history of hepatitis (13.5 versus 2.0% ; P<0.001), exposure to a contact who had had hepatitis (12.5 versus 1.9% ; P<0.001), blood transfusion (7.8 versus 2.3% ; P<0.001), tattoos (36 versus 2.4% ; P<0.001) and intravenous drug use (85.7 versus 1.9% ; P<0.001). However, one third of subjects had no risk factors for HCV infection. The logistic regression analysis confirmed a statistically significant association (P<0.05) between anti-HCV-positivity and intravenous drug use, tattoos, blood transfusion, a history of hepatitis and exposure to a contact who had had hepatitis. Conclusions : These results show almost a five-fold higher prevalence of anti-HCV among patients attending a trauma unit or admitted to hospital for elective surgery than among blood donors.