Routine screening for HIV and hepatitis B in patients undergoing cardiac catheterisation: the need to make it mandatory.

Reuse of catheters during cardiac catheterisation and interventions is a routine practice in our country. However, the reuse of catheters is complicated by the inherent difficulties in adequate sterilisation of these devices. Gas sterilisation with ethylene oxide has been found to be ineffective when residual fluid was present. Recent reports indicate an increased prevalence of blood-borne viral infections especially Hepatitis B virus and Human Immunodeficiency virus in India. We analysed the data of patients from our Institute over the past seven years (1992-1998) who underwent routine screening for Human Immunodeficiency virus and Hepatitis B virus prior to cardiac catheterisation. During this period, the prevalence of Hepatitis B virus increased by 1.5 times and that of Human Immunodeficiency virus by 2.5 fold. In this changed scenario, it is advisable to perform a mandatory screening of all the patients undergoing invasive cardiac procedures so as to minimise the risk of transmission from one patient to another and also to the catheterisation laboratory personnel. In the patients with a positive result, proper precautions can be taken and the entire material used for cardiac catheterisation can be discarded.