Markers of hepatitis viruses and human T-lymphotropic virus types I/II in patients who have undergone open-heart surgery: Evidence of increased risk for exposure to HBV and HEV

Abstract

Background: Open-heart procedure is characterized by a high-risk for contracting blood-borne infections. We evaluated the prevalence of several markers of hepatitis viruses (B-E) and human T-cell lymphotropic virus types I/II (HTLV-I/II) in a consecutive series of patients who had undergone open-heart surgery. Methods: 204 patients and 158 selected age- and sex-matched healthy volunteers were investigated. Samples were collected at least 6-12 months postoperatively. Commercial enzyme immunoassays and confirmatory immunoblot assays for HCV, HEV and HTLV-I/II were used. Results: None of the subjects tested positive for antibodies to HTLV-I/II. Prevalence of markers of past HBV infection and antibodies to HEV (anti-HEV) were higher in patients than in healthy controls (anti-HBc: 45.1% vs. 31%, p = 0.009; anti-HBs: 31.9% vs. 22.2%, p = 0.02; anti-HBe: 32.4% vs. 10.1%, p = 0.000; anti-HEV: 5.4% vs. 0%, p = 0.008). HBsAg and antibodies to HCV did not differ between the groups. Conclusions: HTLV, HBsAg and HCV infection markers did not differ between patients and healthy controls. However, patients had significantly increased prevalence of markers of previous HBV infection suggesting that an intensive vaccination schedule against HBV preoperatively might be helpful in minimizing the risk. The increased prevalence of anti-HEV in cardiac patients requires further investigation. Prospective studies are needed in order to definitely address whether the high prevalence of exposure to HBV and HEV infections in patients who had undergone open-heart surgery is procedure-related or not and whether it has any impact on morbidity of these patients. © 2005 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.