Is Tattooing a Risk Factor for Hepatitis C Transmission?: An Updated Systematic Review and Meta-Analysis

Context The aim of this systematic review was to assess the association of tattooing with the risk of hepatitis C infection. Evidence Acquisition A systematic search was performed in Medline, Web of Science, Scopus, Google scholar, EMBASE, CINAHL, and PubMed up to May 2017. To analyze the data using random effect, odds ratio (OR) with 95% confidence interval (CI) was calculated for each study. We also determined publication bias and heterogeneity among the 162 extracted articles. Results We included 163 relevant studies out of the 2353 extracted studies into the meta-analysis process. When all studies were included in the meta-analysis, the association between tattooing and risk of hepatitis C transmission was strongly significant (pooled OR = 2.79, 95% CI: 2.46 - 3.18). Subgroup analysis showed the strongest association between tattooing and the risk of hepatitis C among samples from blood donors groups (OR = 4.09, 95% CI: 2.80 - 5.98). Conclusions This meta-analysis study revealed that tattooing is strongly associated with transmission of hepatitis C in all subgroups. Relevant education is recommended for young adults who are more likely to get tattoos as well as for prison inmates who have demonstrated high prevalence of hepatitis C infection. In addition, it seems necessary to implement prevention programs and enforce guidelines for safer tattooing practices in tattoo parlors in order to prevent hepatitis C transmission.