ACG: Students Risk HCV by Sharing Body-Piercing Jewelry

LAS VEGAS, Oct. 24 -- College students with pierced nipples, bellybuttons, and other body parts are risking hepatitis C virus infection when they share their jewelry, according to a study reported here.

In addition, few primary care physicians adequately screen college students for established HCV risk factors, reported Julie R. Hollberg, M.D., of the Center for Digestive Care in Ypsilanti, Mich., and colleagues, at the American College of Gastroenterology meeting.

More than half of college students surveyed (55%) had at least one piercing in a body area other than their ears. Of these, about 60% reported that they share their body-piercing jewelry with friends, Dr. Hollberg's study found.

The first documented case of HCV transmission via body-piercing jewelry was published last November in Pediatrics. It involved a belly button ring shared by two 18-year-old girls, Dr. Hollberg said.

Trading earrings, also a common practice, is not likely to spread HCV because ear tissue is largely composed of cartilage, Dr. Hollberg said. But swapping jewelry from areas of the body with more vasculature, which bleed more from piercing and don't heal as well, is riskier, she said.

In other words: "There is more risk when you trade nipple rings than when you trade earrings," Dr. Hollberg said.

The study surveyed more than 600 mostly white undergraduate college students. Sixty-four percent were female, and their average age was 20. The survey assessed the prevalence of established HCV transmission risk factors, such as intravenous drug use, as well as emerging risk factors such as tattoos and body piercing. Key results include:

About 13% reported at least one established risk factor, including risky sex, intravenous drug use, snorting cocaine or other drugs, an abnormal liver test, or having undergone a blood transfusion before 1992.

As far as emerging risk factors, 32% of students had a body piercing in an area other than the earlobe, 24% had tattoos, and about 3% had injected steroids.

Overall, 75% of students reported one or more of these emerging risk factors for HCV.

Many students lacked awareness of established HCV risk factors, the study found. For example, 27% didn't know the virus could be transmitted by IV drug use, and 77% didn't know HCV could be transmitted by sharing a straw when snorting cocaine. Blood often gets into the straw, Dr. Hollberg said.

The study did not ask students if they knew about the potential danger of sharing body jewelry, as the students were unlikely to be aware of this emerging risk factor, Dr. Hollberg said.

Also of concern to the researchers was that 47% of students who had undergone a recent physical exam were asked by their doctor about even one established HCV risk factor. Only 12% were asked about all established risk factors.

The study indicates "an incredible lack of awareness and education regarding hepatitis C among these students," Dr. Hollberg said. Physicians can play a "crucial role" in educating undergraduates about HCV and screening them for the disease, she concluded.