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Tattooing and Risk of Hepatitis B: A Systematic Review and Meta-analysis

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Abstract

Objective

The objective of this systematic review and meta-analysis is to assess the association between tattooing and the risk of transmission of hepatitis B virus.

Methods

A systematic search of MEDLINE, EMBASE, PubMed, Database of Abstracts of Reviews of Effects, ACP Journal Club and BIOSIS Previews was performed up to March 2011.

Results

Forty-two observational studies were included in this systematic review, of which 31 were included in the meta-analysis. Pooled odds ratios (95% confidence intervals) of the association of tattooing and hepatitis B infection was 1.48 (1.30-1.68) when all studies were included in the analysis. Subgroup analysis shows the strongest association between tattooing and risk of hepatitis B among populations involved in high-risk behaviours (OR=1.64, 95% CI: 1.32-2.03).

Conclusion

Findings of the current systematic review and meta-analysis indicate that tattooing is associated with hepatitis B transmission in all subgroups. A population health approach that emphasizes universal hepatitis B immunization, education of young adults who are more likely to get tattoos, and education of prison inmates (who have the highest background rate of hepatitis B infection), along with enforcement of guidelines and safer tattooing practices in prison, are fundamental in prevention of transmission of hepatitis B.

Résumé

Objectif

Nous avons procédé à un examen systématique et à une méta-analyse afin d’évaluer l’association entre le tatouage et le risque de transmission du virus de l’hépatite B.

Méthode

Recherche systématique dans les bases de données MEDLINE, EMBASE, PubMed, DARE (Database of Abstracts of Reviews of Effects), ACP Journal Club et BIOSIS Previews jusqu’en mars 2011.

Résultats

Quarante-deux études observationnelles étaient comprises dans l’examen systématique, dont 31 ont été incluses dans la méta-analyse. Le rapport de cotes combiné (intervalles de confiance de 95 %) de l’association entre le tatouage et l’infection à VHB était de 1,48 (1,30-1,68) lorsque toutes les études étaient comprises dans l’analyse. L’analyse par sous-groupe montre la plus forte association entre le tatouage et le risque d’hépatite B dans les populations s’adonnant à des comportements à risque (RC=1,64, IC de 95 %: 1,32-2,03).

Conclusion

Les résultats de l’examen systématique et de la métaanalyse montrent que le tatouage est associé à la transmission de l’hépatite B dans tous les sous-groupes. Une approche axée sur la santé des populations, qui met l’accent sur la vaccination universelle contre l’hépatite B, la sensibilisation des jeunes adultes, plus susceptibles de se faire tatouer, et la sensibilisation des détenus (qui présentent le plus haut taux naturel d’infection à VHB), ainsi que l’application des lignes directrices et des pratiques de tatouage à moindre risque en prison, sont fondamentales pour prévenir la transmission de l’hépatite B.

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Authors and Affiliations

  1. School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Siavash Jafari MD, MHSC &  Jane A. Buxton MBBS, FRCPC

  2. Division of Pediatric Urology, BC Children’s Hospital, BC, Vancouver, Canada

    Kourosh Afshar MD, MHSC, FRCPC FAAP & Ray Copes MD, MSc

  3. Environmental and Occupational Health, Ontario Agency for Health Protection and Promotion, ON, Toronto, Canada

    Souzan Baharlou MD (Director)

  4. Epidemiologist and Harm Reduction Lead, BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada

    Jane A. Buxton MBBS, FRCPC

Authors
  1. Siavash Jafari MD, MHSC
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  2. Jane A. Buxton MBBS, FRCPC
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  3. Kourosh Afshar MD, MHSC, FRCPC FAAP
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  4. Ray Copes MD, MSc
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  5. Souzan Baharlou MD
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Corresponding author

Correspondence to Jane A. Buxton MBBS, FRCPC.

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Conflict of Interest: None to declare.

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Jafari, S., Buxton, J.A., Afshar, K. et al. Tattooing and Risk of Hepatitis B: A Systematic Review and Meta-analysis. Can J Public Health 103, 207–212 (2012). https://doi.org/10.1007/BF03403814

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  • DOI: https://doi.org/10.1007/BF03403814

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