Determinants of HIV, Hepatitis B, and Hepatitis C Infections Among Preoperative Patients in a Tertiary Hospital in the Eastern Democratic Republic of Congo.

BACKGROUND

Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) are three of the most common occupational infections due to blood-borne infectious diseases. Surgeons are particularly at risk, especially in countries with high endemicity, such as the Democratic Republic of the Congo (DRC). Assessing the burden of these viruses among preoperative patients could help evaluate the level of risk.

METHODS

This was a retrospective cross-sectional study carried out in the departments of Surgery and Gynecology of a tertiary care hospital in Bukavu, in eastern DRC. Standard enzyme immunoassays were used to determine the serology for HIV (anti-HIV Ab), HBV (HBsAg), and HCV (anti-HCV Ab) as a part of the routine minimum preoperative assessment. The frequency and risk factors of positive tests were evaluated, as well as factors for non-performance of these tests.

RESULTS

Of patients who underwent surgery (2092), only 1871 performed at least one serological test (89.4%). A positive HIV serology test was observed in 39/1861 patients (2.1%), while 69/1870 and 43/1871 patients had reactivity to HBsAg (3.37%) and anti-HCV (2.29%), respectively. The female/male ratio showed statistically significant differences for these three viruses, respectively. Among the risk factors studied, age and male gender appear to influence HBsAg and anti-HCV reactivity, whereas a history of transfusion or tattooing was found to be statistically significant in patients with positive HBsAg serology, and previous surgery has been more commonly observed in cases of anti-HCV reactivity.

CONCLUSION

The rate of HIV, HBV, and HCV infection in this patient population was similar to that of the national level, although higher rates are observed among some subgroups. In any case, surgeons should maintain systematic universal protective measures since the cost-effectiveness of screening based on the presence of risk factors has not yet been clearly demonstrated.