Montecalvo M A, Lee M S, DePalma H, Wynn P S, Lowenfels A B, Jorde U, Wuest D, Klingaman A, O'Brien T A, Calmann M
Division of Infectious Diseases, New York Medical College, Valhalla, USA.
Infect Control Hosp Epidemiol. 1995 Nov;16(11):627-32. doi: 10.1086/647026.
To determine the proportion of major surgical procedures that involve patients having serologic evidence of infection with human immunodeficiency virus-1 (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) in a single center in Westchester County, New York.
Blood samples sent for transfusion screening or cross-match were tested blindly for HIV antibody (anti-HIV), HBV core antibody, HBV surface antigen (HBsAg), and HCV antibody (anti-HCV). Demographic characteristics and operation category were correlated with serologic results by univariate and regression analyses.
Of 1,062 operations evaluated, 71 (6.7%, 95% confidence interval [CI95], 5.2% to 8.4%) were performed on patients with either anti-HIV, HBsAg, or anti-HCV. In 17 (1.6%, CI95, .93% to 2.5%) of these operations, the patient evidenced anti-HIV; in 15 (1.4%; CI95, .79% to 2.3%), HBsAg; and in 55 (5.2%, CI95, 3.9% to 6.7%), anti-HCV. Anti-HCV was detected significantly more often than anti-HIV (5.2% versus 1.6%, P < .001) or HBsAg (5.2% versus 1.4%, P < .001). Operations involving women aged 25 to 44 years had the highest proportion with serologic evidence of at least one of the three viruses (17.2%); of anti-HCV (15.3%); and of anti-HIV (6.7%). Logistic regression analysis found that being in the 25- to 44-year age group was associated significantly with infection with any virus (P < .001) and with anti-HCV (P < .001). The strongest logistic predictors of anti-HIV seropositivity were having anti-HCV seropositivity (P < .001), being age 25 to 44 years (P < .001), and having a general surgery operation (P = .002).
The prevalences of serologic evidence of at least one of the three viruses (16.7%), of anti-HCV (14.5%), and of anti-HIV (5.6%) are high in patients aged 25 to 44 years undergoing major surgery at a tertiary-care medical center located in Westchester County, New York. Anti-HCV is more prevalent than anti-HIV or HBsAg and is predictive of anti-HIV seropositivity. Testing for anti-HIV alone would have detected only 24% of patients infected with a bloodborne pathogen. These data strongly underscore the importance of universal precautions.
确定在纽约韦斯特切斯特县的一个单一中心，涉及有人类免疫缺陷病毒1型（HIV）、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染血清学证据患者的大手术比例。
对送检进行输血筛查或交叉配血的血样进行HIV抗体（抗-HIV）、HBV核心抗体、HBV表面抗原（HBsAg）和HCV抗体（抗-HCV）的盲测。通过单因素分析和回归分析将人口统计学特征及手术类别与血清学结果相关联。
在评估的1062例手术中，71例（6.7%，95%置信区间[CI95]，5.2%至8.4%）是对有抗-HIV、HBsAg或抗-HCV的患者进行的。在这些手术中的17例（1.6%，CI95，0.93%至2.5%）中，患者有抗-HIV证据；15例（1.4%；CI95，0.79%至2.3%）有HBsAg；55例（5.2%，CI95，3.9%至6.7%）有抗-HCV。抗-HCV的检测频率显著高于抗-HIV（5.2%对1.6%，P <.001）或HBsAg（5.2%对1.4%，P <.001）。涉及25至44岁女性的手术中，有三种病毒中至少一种血清学证据的比例最高（17.2%）；有抗-HCV的比例（15.3%）；有抗-HIV的比例（6.7%）。逻辑回归分析发现，处于25至44岁年龄组与感染任何病毒（P <.001）和抗-HCV（P <.001）显著相关。抗-HIV血清学阳性的最强逻辑预测因素是抗-HCV血清学阳性（P <.
