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| LETTER TO EDITOR |
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| Year : 2017 | Volume
: 31
| Issue : 2 | Page : 134-135 |
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Iatrogenic hepatitis - A term medical personnel are reluctant to use
Immad Arif, Salman Assad
Department of Gasteroenterology, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| Date of Web Publication | 20-Apr-2017 |
Correspondence Address:
Salman Assad
Department of Gasteroenterology, Shifa Tameer-e-Millat University, Islamabad, Pakistan
Pakistan
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0972-4958.204825
How to cite this article:
Arif I, Assad S. Iatrogenic hepatitis - A term medical personnel are reluctant to use. J Med Soc 2017;31:134-5 |
Sir/Madam,
Iatrogenic causes remain one of the major risk factors for the spread of hepatitis virus, yet it is seen that medical personnel are reluctant to use the term iatrogenic hepatitis. Is it because it is not recognized as a serious problem, or are health-care professionals oblivious to it.
It is estimated that globally there are 170 million people living with chronic hepatitis C virus (HCV) infection, and almost 500,000 people in the year 2010 have died from HCV-related liver disease. Although data vary widely across regions, the most recent estimates indicate the prevalence of HCV infection is (<2%) in the United States and other developed countries. The prevalence is higher (≥ 2%) in several countries in Eastern Europe and the former Soviet Union, Latin America, and certain countries in the Middle East, South Asia, and Africa; Egypt is reported to have the highest prevalence (approximately 10%). Sharing of drug injection equipment is the most frequent mode of transmission in most developed countries. In countries where HCV is more common, the predominant mode of transmission is from health-care exposures where infection control practices are poor and from unsafe injections.[1]
Iatrogenic causes remain one of the leading risk factors for the transmission of HCV in developing countries. In a study conducted to look at risk factors of HCV in a developing country with a high prevalence of hepatitis C, hospital admission, blood transfusion, surgeries, endoscopy, complicated deliveries, injection therapy, history of frequent injections, and dental treatment were the most common risk factors. Even though the risk of transmission through blood transfusion has greatly decreased in the developed world due to screening procedures, it remains a risk in developing countries.[2] Looking at risk factors in nondrug users, another study found iatrogenic factors to be a significant risk factor. These included hospital admission, surgery, intravenous infusions, intravenous injections, birth delivery, cesarean section, and dental procedures.[3]
Hospitals and health-care workers are required to work under strict infection control and barrier protection rules. Yet, looking at data showing iatrogenic causes as a major risk factor raises a lot of questions. It is true that medical errors do take place but such high numbers of infections spread through iatrogenic causes point toward medical negligence. It can only be assumed that hospitals and health-care workers either do not have a policy in place to prevent the iatrogenic spread of hepatitis or they fail to implement and observe it.
As it is known that disinfection and autoclave measures used for medical instruments are never 100% effective as is the same with scrubs, we recommend the use of a disposable rather than a separate set of instruments and equipments for both hepatitis C positive and negative (normal) patients. Similarly, disposable gowns can be used for such cases. It is also highly recommended that elective procedures and operations should be performed at the end of each operation day, so operation theaters can be properly disinfected overnight. It may seem farfetched, but work should be done to make disposable instruments that are affordable and which the patients can buy to prevent the spread of iatrogenic hepatitis. We have to open the discussion now toward leading threats of this iatrogenic transmission since people developing hepatitis after medical and surgical procedures are on the rise.
Proper infection control methods and education regarding the iatrogenic spread of hepatitis should be given at all health-care facility and health-care professionals should undergo formal training to prevent such events. The use of the term iatrogenic hepatitis without hesitation by health-care professionals will put more focus on this very serious issue and hopefully help in health-care workers to acknowledge the real situation and how to changes made by them prevent it.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Dore GJ. The changing therapeutic landscape for hepatitis C. Med J Aust 2012;196:629-32.  |
| 2. | Medhat A, Shehata M, Magder LS, Mikhail N, Abdel-Baki L, Nafeh M, et al. Hepatitis C in a community in Upper Egypt: Risk factors for infection. Am J Trop Med Hyg 2002;66:633-8. |
| 3. | Mohsen A, Bernier A, LeFouler L, Delarocque-Astagneau E, El-Daly M, El-Kafrawy S, et al. Hepatitis C virus acquisition among Egyptians: Analysis of a 10-year surveillance of acute hepatitis C. Trop Med Int Health 2015;20:89-97. |
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