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Pre-endoscopy Screening in the Endoscopy Units of Underdeveloped and Developing Counties: Still Debatable Issue?
Ashish Kumar Jha, Madhur Chaudhary, Ravish Ranjan, Pallavi Singh, Vishwa Mohan Dayal, Sharad Kumar Jha, Uday Kumar, Amitesh Kumar
Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna-14, India.

Corresponding Author
Dr Ashish Kumar Jha


Background: The risk of transmission of hepatitis viruses via endoscopes is potentially a concern for patients and healthcare workers. We aimed to determine the prevalence of HBV and HCV infections among patients scheduled for esophagogastroduodenoscopy in a teaching hospital in eastern India. 
Methods: In a cross-sectional study from January 2016 to March 2017, all consecutive patients attending the GI endoscopy unit for esophagogastroduodenoscopy were screened for hepatitis B and C infection. 
Results: A total of 2,499 patients scheduled for endoscopy were screened for hepatitis B and C viruses. Out of 2,499 patients, 221(8.84%) were tested positive for HBsAg. The mean (SD) age was 42.13 (±15.08) years (M: F ratio 4:1). Thirty six (1.44%) patients were tested positive for anti-HCV antibody. The mean (SD) age was 51.25 (±11.78) years (M:F ratio 1:1.6). Out of 2,499 patients, 123 and 19 patients were previously diagnosed cases of HBV and HCV related chronic liver disease, respectively. Prevalence of newly diagnosed cases of HBV and HCV infection in patients attending endoscopy unit were 4.15% and 0.72%, respectively. Identifiable risk factors was absent in 57% and 27.77% of HBV and HCV patients, respectively.
Conclusion: Prevalence of HBV and HCV infection in patients undergoing endoscopy in a teaching hospital of the eastern India were 8.84% and 1.44%, respectively. Pre-endoscopy screening is neither cost effective nor recommended by the international bodies. Further study is warranted to assess the adequacy of infrastructure, risk of hepatitis virus transmission, and the cost benefit of getting viral serology in the endoscopy units of underdeveloped and developing counties.