Seroprevalence of blood borne transmissible diseases in trauma orthopaedic surgical patients.

OBJECTIVE: The purpose of this study is to determine the seroprevalence of blood borne transmissible diseases of the orthopaedic trauma surgical patients who deny or did not have knowledge of having disease or risk factors, but are positive for either human immunodeficiency virus, hepatitis B virus, and hepatitis C virus. BACKGROUND: Orthopaedic surgeons practicing in areas with a high prevalence of HIV infection may expect that up to 7% of their patients who undergo emergency procedures and 1% to 3% of those who undergo elective surgery will be HIV-positive. METHOD: All conscious adult patients consecutively admitted for surgical management by the orthopaedic service were evaluated. A detailed questionnaire was completed asking the patient of knowledge of having a transmissible disease and documenting certain risk factors. Blood samples were taken to test for HIV, HBV and HCV and all positive patients were sent to a follow up clinic. RESULTS: Out of 100 patients the following results were found: 7% were positive for HIV, 12% positive for HBV, 12% positive for HCV, 19% were positive to at least one test, and 9% were positive in more than one test. Of the one hundred patients, 6% had a positive test in spite of denying having a disease or any risk factors. None of the patients with HBV and/or HCV knew they were positive and three (43%) of the seven with HIV were also unaware of their condition. CONCLUSIONS: This study suggests that a worrisome number of patients are seropositive for a blood borne transmissible disease, even though they had no knowledge of such disease and claimed they had no risk factors. In order to protect orthopaedic surgeons from the unreliability of some patients' histories, all trauma orthopaedic surgical patients should be managed with universal precautions.