Patients with hepatitis C may be at higher risk for PJI, revision TJA for aseptic failure
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Patients diagnosed with hepatitis C virus are at a higher risk for periprosthetic joint infections and revision for aseptic failure after total hip and knee arthroplasties, according to recently presented results.
Emanuele Chisari, MD, a research fellow at Rothman Orthopaedic Institute, presented findings on incidence of periprosthetic joint infections (PJI) in patients with HCV at the Musculoskeletal Infection Society Annual Meeting. The meeting was held virtually.
“We found 214 THA and TKA patients that were then matched with a propensity score matching 3:1 for age, sex, BMI, year of surgery and joint affected with 642 otherwise healthy individuals,” Chisari said in the presentation. “We then hypothesized [that] in our cohort we will find that a hepatitis C diagnosis was not associated with PJI, and we set a primary endpoint PJI risk of 2 years after surgery. [For] our secondary outcomes, we were looking at were aseptic revision, discharge to a rehab facility and other short-term outcomes,” he said.
Chisari and colleagues used a chart review to document proof of aviremia after treatment, also known as sustained viral response (SVR), after treatment for HCV.
After performing logistic bivariate regression, the researchers found HCV was an independent risk factor for PJI and aseptic revisions with an overall increased incidence among patients with HCV.
“The incidence of PJI was 5.14% among patients with hepatitis C which was found to be significantly higher compared to the control group,” Chisari said. “When our subgroup analysis of patients with documented SVR was done, we found the incidence of PJI in this group was 9.5%,” he added.
Chisari and colleagues also concluded that patients who received treatment for HCV before undergoing TJA have a “substantially lower risk of infections and revision” and that further studies are needed to investigate the aseptic failures that were due to undetected infections.
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Chisari E, et al. Presentation 34. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 7-8, 2020 (virtual meeting).
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