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Effect of Tattooing, Body Piercing and Intranasal Drug Use on Risk of HCV and HBV Infection

In recent years, there has been growing concern among medical professionals and hepatitis B and C community service providers that certain cosmetic procedures, including tattooing and body piercing -- as well as intranasal drug use -- might be associated with an increased risk for hepatitis C virus (HCV) and hepatitis B virus (HBV) infection.

To explore this issue, researchers at the University of Texas School of Public Health in Houston and the U.S. Centers for Disease Control and Prevention (CDC) conducted a cross-sectional seroprevalence study of a population with a low frequency of injection drug use. Students 18 years and older from eight college campuses in Houston were invited to participate.


bullet Of the 7,960 participants who completed an anonymous self-administered questionnaire and provided a blood sample, 5,282 U.S.- or Canadian-born participants were analyzed.
bullet The median age was 21, 62% were female, 42% were white, 26% were black, 2% were Hispanic, and 10% were Asian or other race/ethnicity.
bullet 2% of participants reported injection drug use and 13.7% reported intranasal drug use.
bullet 21.2% reported having body piercings and 25.2% reported having tattoos.
bullet The overall prevalence of HCV infection was 0.9%.
bullet The overall prevalence of HBV infection was 5.2%.
bullet Higher HCV prevalence was independently associated with:

bullet increasing age;
bullet history of injection drug use;
bullet blood transfusion before 1991;
bullet incarceration.
bullet Among 5,066 students who denied injecting drugs, the HCV prevalence rates were:
bullet 0.8% for those who reported intranasal drug use;
bullet 0.6% for those who reported tattoos;
bullet 0.6% for those who reported body piercing.
bullet Increased HBV prevalence was associated with high-risk sexual behaviors and black or Asian race.


Based on these results, the authors concluded, "There was no increased risk for HCV or HBV infection in low-risk adults based solely on history of cosmetic procedures or snorting drugs. However, proper infection control practices for cosmetic procedures should be followed, illegal drug use discouraged, and hepatitis B vaccination provided to adolescents and sexually active adults."

 L-Y Hwang, J R Kramer, C Troisi, and others. Relationship of cosmetic procedures and drug use to hepatitis C and hepatitis B virus infections in a low- risk population. Hepatology 44(2): 341-351. August 2006.  

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