Tattooing and the risk of transmission of hepatitis C: a systematic review and meta-analysis

Objectives: In this systematic literature review we sought to determine whether tattooing is a risk factor for the transmission of hepatitis C. Methods: A comprehensive search was performed to identify all case-control, cohort or cross sectional studies published prior to November 2008 that evaluated risks related to tattooing or risk factors of transmission of hepatitis C infection. Results: A total of 124 studies were included in this systematic review, of which 83 were included in the meta-analysis. The pooled odds ratio (OR) and 95% confidence interval (CI) of the association of tattooing and hepatitis C from all studies was 2.74 (2.38-3.15). In a subgroup analysis we found the strongest association between tattooing and risk of hepatitis C for samples derived from non-injection drug users (OR 5.74, 95% CI 1.98-16.66). Conclusions: Findings from the current meta-analysis indicate that tattooing is associated with a higher risk of hepatitis C infection. Because tattooing is more common among the youth and young adults and hepatitis C is very common in the imprisoned population, prevention programs must focus on youngsters and prisoners to lower the spread of hepatitis infection. (C) 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.