The prevalence of hepatitis C in a regional level I trauma center population.

Abstract

Several studies have examined the prevalence of hepatitis B (HBV) and human immunodeficiency virus (HIV) in a trauma population. To our knowledge, no one has reported on the prevalence of hepatitis C (HCV). We prospectively studied the prevalence of HCV, as well as HBV, HIV, and syphilis in our adult regional level I trauma center population. Two hundred eighty-six consecutive trauma patients were tested for previous exposure to HCV using an anti-HCV mAb ELISA. Patients were also tested for exposure to HBV, HIV, and syphilis, and for illicit drug use. All rho values were calculated using Yates' corrected chi 2 or Student's t test. Twenty-two patients (7.7%) were found to have anti-HCV antibodies, five patients (1.7%) had active HBV, nine patients (3.2%) had HIV, and 16 patients (6%) were positive by RPR. Four (18%) of the patients seropositive for HCV tested positive for HBV, HIV, or syphilis as well. The HIV-positive patients were more likely than the HIV-negative patients to be HCV positive (rho = 0.018). Nine of the HCV seropositive patients (41%) tested positive for cocaine use. Cocaine users were more likely than nonusers to be HCV positive (rho = 0.0007). We have demonstrated the prevalence of HCV in our trauma population to be high (7.7%). It is well known that HCV has a high rate of chronicity, thus up to 90% of these patients are carriers and represent a substantial risk to health care workers. The two significant risk factors, HIV status and cocaine use, are difficult to elicit in the acute setting, reinforcing the need for adhering to universal precautions.