Background: Several infectious diseases have been found to be associated with tattooing, including some transfusion-transmitted diseases (TTDs). Information on tattooing has been included in screening interviews of prospective blood donors and may be a reason for deferral.

Methods: Review of articles identified through Medline (and other computerized data bases) using medical subject heading (MeSH) terms and textwords for "tattooing," "transfusion," "hepatitis," "human immunodeficiency virus," "acquired immunodeficiency syndrome," "syphilis," "Chagas disease," "infection," "risk factors," and their combinations.

Results: There is strong evidence for the transmission of hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, and syphilis by tattooing. Tattooing may also transmit the human immunodeficiency virus (HIV), although convincing evidence is still lacking. There is little or no evidence that other TTDs can be transmitted by tattooing. Epidemiologic studies to date have shown a large variation in odds ratio estimates of the association between tattooing and HBV, HCV, and HIV infections.

Conclusions: Further studies are required to clarify the risk of tattoos in transmitting infectious diseases through blood transfusions. A reassessment of tattoos as a screening criterion among blood donors is justified.

Key Words: AIDS, Chagas disease, hepatitis B, hepatitis C, HIV, risk factors, syphilis, tattooing, transfusion-transmitted diseases

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