Surveillance and analysis of risk factors for hepatitis B and C among tattooists and piercers and individuals with multiple tattoos or piercings.

Hepatitis C (HCV) is a bloodborne infectious disease. In approximately 55-85%
of the cases patients will become chronically infected. An estimated 20-30% of
the chronically infected will develop liver cirrhosis after approximately 30
years. In 3-5% of the cases this will cause major health problems on the long
term, for instance liver failure and liver cancer.
Till now, little data is available about the prevalence of HCV in the
Netherlands, among the general population as well as among risk groups. In 2001
HCV treatment has improved substantially. Therefore, in 2004 the Dutch Health
Counsil advised to trace HCV risk groups and inform them about the risks and
improved treatment options. They also advised to perform epidemiological
studies to gain insight into the spread of HCV in the Netherlands.
This study is in line with the advice of the Dutch Health Counsil. It aims to
gain insight into the prevalence of HCV among a risk group: tattooists and
piercers and individuals with multiple tattoos or piercings.
Based on the results of this study it can be advised to regularly screen all
tattooists and piercers on HCV and to start prevention campaigns. Participants
might obtain their test result, but might also decide not to. HCV positive
tattooists and piecers who choose to contact the Health Services for their
testresult, will be referred for further diagnostic measures and treatment.
Furthermore, based on the results of this study, individuals who want to have a
tattoo or piercings can be informed about possible HCV risks.


Tattooists en piercers and individuals with multiple tattoos or piercings might
also have an increased risk for hepatitis B. HBV is also a bloodborne infection
but can also be spread by sexual contact. About 10% of the patients will become
chronically infected with HBV. A chronic infection might cause a serious
liverinfection or livercirrhosis. Because of the serious complications and the
infectiousness of HBV and the fact that an infection might be asymptomatic, it
is important to detect the infection at an early stage. A chronic infection
needs treatment. There is a vaccination available for HBV. Risk groups,
household contacts of HBV infected persons and patient with other chronic liver
diseases are advised to get a HBV vaccine.

Based on the HBV test results, information campaigns can be started to prevent
further spread within our study population. Participants who decide to obtain
their test result will get the first HBV vaccination for free. Chronically
infected participants will be referred fot treatment.

To gain insight into the prevalence of HBV and HCV and risk factors for HBV and
HCV among (former) tatooists and piercers and individuals with multiple tattoos
or piercings.

The hepatitis study is a cross-sectional observational study.

The burden associated with participating in this study consists of drawing two
blood samples by venapuncture and filling out a questionnaire. There are almost
no risks associated with drawing a blood sample.
It would take approximately 20-30 minutes to fill out the questionnaire and to
draw the blood sample.