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Tattooing independently associated with increased HCV exposure risk

Individuals with one or more tattoos were at increased risk for hepatitis C regardless of the absence of other risk factors, according to recent results.

In a multicenter case-control study, researchers evaluated data from 3,871 patients, including 1,930 with chronic HCV and 1,941 HCV-negative participants. All patients responded to a demographic questionnaire and their exposure to potential risk factors for HCV, including having at least one tattoo.

Fritz François

“Since hepatitis C is a chronic condition that might not come to light for many years after exposure, the true prevalence of the disease might be underestimated,” researcher Fritz François, MD, MSc, FACG, associate dean for Diversity and Academic Affairs at New York University Langone Medical Center, told Healio.com. “Along with this is the observation that the popularity of tattooing has increased significantly, and this provides an opportunity for transmission of blood-borne pathogens such as HCV.”

Patients with HCV were more likely than those without to have one or more tattoos after adjusting for confounders including age, sex, race/ethnicity, alcohol and drug use, sexual activity and socioeconomic status (adjusted OR=3.74; 95% CI, 2.95-4.73). Participants with HCV also were more likely to report use of injection drugs (65.9% of participants compared with 17.8% of those without HCV) or to have received a blood transfusion before 1992 (22.3% vs. 11.1%) (P<.001 for both).

Among participants who reported no injection drug use or pre-1992 blood transfusions (n=1,886, including 465 with HCV), those with HCV were significantly more likely to have one or more tattoos (adjusted OR=5.17; 95% CI, 3.75-7.11). This elevated risk persisted after exclusion of participants who reported intranasal drug use (adjusted OR=8.22; 95% CI, 5.45-12.40).

“Tattooing poses a risk for hepatitis C exposure independent of other traditional risk factors such as injection drug use or blood transfusion prior to 1992,” François said. “HCV is [approximately] four times more likely to be found among patients with tattoos compared to those without tattoos. Given the increased prevalence of tattooing, physicians should be prepared to provide these patients with counseling regarding blood-borne pathogens and HCV screening.”