Meta‐analysis: Risk of hepatitis C virus infection associated with hospital‐based invasive procedures

Paul Henriot (1, 2) , Mathieu Castry (3) , Liem Binh Luong Nguyen (4) , Yusuke Shimakawa (5, 2) , Kévin Jean (1, 2) , Laura Temime (1, 2)

1 MESuRS - Laboratoire Modélisation, épidémiologie et surveillance des risques sanitaires
2 PACRI - Pasteur-Cnam Risques infectieux et émergents
3 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
4 CIC 1417 - CIC Cochin Pasteur
5 Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology

Background Healthcare settings, where invasive procedures are frequently performed, may play an important role in the transmission dynamics of blood-borne pathogens when compliance with infection control precautions is suboptimal. Aims To understand and quantify the role of hospital-based invasive procedures on hepatitis C virus (HCV) transmission. Methods We conducted a systematic review and meta-analysis to identify recent studies reporting association measures of HCV infection risk that are linked to iatrogenic procedures. Based on expert opinion, invasive procedures were categorised into 10 groups for which pooled measures were calculated. Finally, the relationship between pooled measures and the country-level HCV prevalence or the Healthcare Access and Quality (HAQ) index was assessed by meta-regression. Results We included 71 studies in the analysis. The most frequently evaluated procedures were blood transfusion (66 measures) and surgery (43 measures). The pooled odds ratio (OR) of HCV infection varied widely, ranging from 1.46 (95% confidence interval: 1.14–1.88) for dental procedures to 3.22 (1.7–6.11) for transplantation. The OR for blood transfusion was higher for transfusions performed before 1998 (3.77, 2.42–5.88) than for those without a specified/recent date (2.20, 1.77–2.75). In procedure-specific analyses, the HCV infection risk was significantly negatively associated with the HAQ for endoscopy and positively associated with HCV prevalence for endoscopy and surgery. Conclusions Various invasive procedures were significantly associated with HCV infection. Our results provide a ranking of procedures in terms of HCV risk that may be used for prioritisation of infection control interventions, especially in high HCV prevalence settings.

Domaines: Sciences du Vivant [q-bio]

Paul Henriot, Mathieu Castry, Liem Binh Luong Nguyen, Yusuke Shimakawa, Kévin Jean, et al.. Meta‐analysis: Risk of hepatitis C virus infection associated with hospital‐based invasive procedures. Alimentary Pharmacology & Therapeutics (Suppl), 2022, 56 (4), pp.558-569. ⟨10.1111/apt.17106⟩. ⟨hal-03726511⟩