Zubia Masood, Masood Jawaid, Rehan Abbas Khan, Shafiqur Rehman.
Screening for Hepatitis B & C: A routine preoperative investigation?.
Pak J Med Sci Jan ;21(4):455-9.

Objective: To find out the seroprevalence of HBsAg and Anti-HCV and to evaluate associated risk factors in patients admitted for elective surgery in a tertiary care public hospital of Karachi. Design: Descriptive serological analysis. Setting: Surgical Unit IV, Civil Hospital, Karachi. Patients and Methods: All patients admitted for elective surgery from February 1, 2004 to September 30, 2004 were included. HBsAg and Anti HCV screening was done in all patients with Enzyme Linked Immunosorbent Assay (ELISA) during the preoperative period. The information was collected by a specially designed proforma that included current and previously known hepatitis profile, risk factors and history of vaccination apart from demographic data. Main Outcome Measures: Seroprevalence of HBsAg and anti HCV, different risk factors. Results: A total of 387 patients were admitted for elective surgical procedure during the study period. It included 221 (57.1%) males and 166 (42.9%) females. After screening HBsAg was positive in 25 (6.5%) of patients, anti HCV in 44 (11.3%) of patients while 6 (1.5%) were positive for both HBsAg and anti HCV. A vast majority of patients gave history of frequent use of intravenous and intramuscular medication i.e. 24 (96%) in HBsAg positive and 42 (95.5%) for anti HCV positive patients, followed by blood transfusion where HBV seropositivity was found in 21 (84.0%) while HCV seropositivity was in 38 (86.3%). History of previous surgical procedures was present in 15 (60%) of HBsAg positive and 28 (63.6%) of Anti HCV positive patients. History of jaundice was present in 12 (48.0%) in HBV seropositive and 22 (50%) in HCV seropositive patients. Three patients were previously known seropositive for hepatitis B and two for hepatitis C. None of patients had vaccination against hepatitis B. Conclusion: The prevalence of HBsAg and anti-HCV in hospitalized surgical patients is very high. There is lack of routine serological screening in our hospitals prior to surgery which is one of the factors responsible for increasing the disease transmission. The major risk factors include re-use of contaminated syringes, contaminated surgical instruments and blood products.

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