Bloodborne Viral Infections: Seroprevalence and Relevance of Preoperative Screening in Indian Eye Care System - A Retrospective Study

Overview

Journal Indian J Ophthalmol

Specialty Ophthalmology

Date 2023 Dec 15

PMID 38099360

Authors

Anil B Gangwe

Samrat Chatterjee

Abhishek Singh

Deepshikha Agrawal

Diksha Rahangdale

Raj Vardhan Azad

Affiliations

Soon will be listed here.

Abstract

Purpose: To report the seroprevalence of bloodborne viral infection (BBVI) in patients undergoing ophthalmic surgeries and assess the utility and feasibility of preoperative screening for BBVI in India's current eye care system.

Methods: This retrospective, hospital-based, descriptive study included data from patients undergoing preoperative screening for Hepatitis B virus (HBV), Hepatitis C virus (HCV), and human immunodeficiency virus (HIV) at a tertiary eye care institute from 2018 to 2022. Rapid diagnostic tests (RDTs) were performed on the blood samples after obtaining informed consent from the patients. Seroreactive patients underwent surgery with additional safety precautions. The demographic data and surgical details of these patients were collected and analyzed. ANOVA was used to carry out statistical analysis between groups. During the study period, the number of healthcare workers (HCWs) sustaining needle stick injury (NSI) and accidental sharp injury (ASI) in the operating theater (OT) and details of these injuries were recorded.

Results: Samples from 28,563 patients were included. The seroprevalence of BBVI was 1.87% (536/28563). Hepatitis B virus (322, 60.1%) was the most commonly detected infection, and HIV (59, 11%) was the least detected infection. The mean age of the seroreactive patients was 60.3 ± 30.8 years. The incidence of NSI was 0.49/1000 surgeries. Nurses (11) and technicians (4) in the OT sustained maximum NSI. None of the HCWs had seroconversion after NSI.

Conclusion: The overall seroprevalence of BBVI in the current study is lower than that reported in previously published studies from eye care organizations. Currently, mandatory preoperative screening for BBVI to prevent transmission of these infections to HCWs working in the eye care sector in India appears to be less cost-effective.

References

Tanner J, Parkinson H . Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev. 2006; (3):CD003087. PMC: 7173754. DOI: 10.1002/14651858.CD003087.pub2. View

Mehta A, Rodrigues C, Ghag S, Bavi P, Shenai S, Dastur F . Needlestick injuries in a tertiary care centre in Mumbai, India. J Hosp Infect. 2005; 60(4):368-73. DOI: 10.1016/j.jhin.2004.12.015. View

Ahmed R, Bhattacharya S . Universal screening versus universal precautions in the context of preoperative screening for HIV, HBV, HCV in India. Indian J Med Microbiol. 2013; 31(3):219-25. DOI: 10.4103/0255-0857.115623. View

Ghauri A, Amissah-Arthur K, Rashid A, Mushtaq B, Nessim M, Elsherbiny S . Sharps injuries in ophthalmic practice. Eye (Lond). 2011; 25(4):443-8. PMC: 3171230. DOI: 10.1038/eye.2011.13. View

Bali J, Bali O, Sahu A, Boramani J, Deori N . Health economics and manual small-incision cataract surgery: An illustrative mini review. Indian J Ophthalmol. 2022; 70(11):3765-3770. PMC: 9907292. DOI: 10.4103/ijo.IJO_1266_22. View

Rewri P, Sharma M, Lohan A, Singh D, Yadav V, Singhal A . Practice pattern of cataract surgeons when operating on seropositive patients. Indian J Ophthalmol. 2019; 67(3):335-339. PMC: 6407377. DOI: 10.4103/ijo.IJO_1437_18. View

Beltrami E, Williams I, Shapiro C, Chamberland M . Risk and management of blood-borne infections in health care workers. Clin Microbiol Rev. 2000; 13(3):385-407. PMC: 88939. DOI: 10.1128/CMR.13.3.385. View

Zhang Z, Gao X, Ruan X, Zheng B . Effectiveness of double-gloving method on prevention of surgical glove perforations and blood contamination: A systematic review and meta-analysis. J Adv Nurs. 2021; 77(9):3630-3643. DOI: 10.1111/jan.14824. View

Premkumar M, Chawla Y . Chronic Hepatitis B: Challenges and Successes in India. Clin Liver Dis (Hoboken). 2021; 18(3):111-116. PMC: 8518333. DOI: 10.1002/cld.1125. View

10.

Ambastha A, Kusumesh R, Bhasker G . Why Should Viral Markers Be Mandatory in Ocular Surgeries: A Hospital Based Retrospective Study. J Clin Diagn Res. 2016; 10(10):LC09-LC11. PMC: 5121698. DOI: 10.7860/JCDR/2016/21386.8713. View

11.

Rewri P, Sharma M, Vats D, Singhal A . Seroprevalence, risk associations, and cost analysis of screening for viral infections among patients of cataract surgery. Indian J Ophthalmol. 2018; 66(3):394-399. PMC: 5859593. DOI: 10.4103/ijo.IJO_726_17. View

12.

Rishi E, Shantha B, Dhami A, Rishi P, Rajapriya H . Needle stick injuries in a tertiary eye-care hospital: Incidence, management, outcomes, and recommendations. Indian J Ophthalmol. 2017; 65(10):999-1003. PMC: 5678339. DOI: 10.4103/ijo.IJO_147_17. View

13.

Scardino P . A hazard surgeons need to address. Nat Clin Pract Urol. 2007; 4(7):347. DOI: 10.1038/ncpuro0854. View

14.

Goel A, Seguy N, Aggarwal R . Burden of hepatitis C virus infection in India: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2018; 34(2):321-329. DOI: 10.1111/jgh.14466. View

15.

Mansour A . Needlestick injuries in ophthalmology. Ophthalmic Surg. 1989; 20(5):367-9. View

16.

Mishra D, Singh H, Gogate P, Bhushan P, Singh M, Srivastav T . Prevalence of incidental and total human immunodeficiency virus, hepatitis B and hepatitis C seropositivity among patients posted for cataract surgery at a tertiary care center in India. Indian J Ophthalmol. 2022; 70(2):400-404. PMC: 9023954. DOI: 10.4103/ijo.IJO_1970_21. View