Thinking about getting a little artwork added to your epidermis?

        A recent study from the University of Texas Southwestern Medical Center in Dallas suggests you might want to think again.

        But there's some debate about the Texas study, which characterizes tattooing as a key infection route for hepatitis C, a potentially fatal virus affecting the liver, and a risk factor for cirrhosis and liver cancer.

        Of the patients studied, 18 percent had tattoos, and 22 percent of the patients with tattoos had hepatitis C. Researchers say few of the tattoo-associated infections could be traced to injection-drug use, blood transfusions or other known risk factors.

        Only 3.5 percent of the patients without tattoos had hepatitis C.

        Dr. Robert Haley, lead author of the study, published in March in the journal Medicine,says the data suggests tattooing is an “important risk factor” for hepatitis C infection.

        Hepatitis C is transmissible through blood and other body fluids. In tattooing, if needles aren't sterilized between patients, or if a clean needle is set down on a surface bearing contaminated blood, the virus could be transmitted from customer to customer.

        Several states, including Ohio, require tattoo parlors to be inspected and licensed. The Ohio Department of Public Health has little data on hepatitis C infections, says spokesman Jay Carey, and no data linking any cases of the disease to tattooing.

        But as tattoos become more popular, the link between skin art and hepatitis C “is something that becomes a big concern to those of us who deal with chronic diseases like hepatitis C,” says Dr. Kenneth Sherman, the director of hepatology and liver transplant medicine at the University of Cincinnati.

        In spite of the inspection requirements, Dr. Sherman is concerned that not all tattoo artists are as expert or as cautious as they should be in preventing contamination.

        Hepatitis C is difficult to trace, because the virus can linger in the body for years before symptoms become apparent. By the time the patient knows he or she has the disease, it's difficult to identify how they may have gotten it.

        The Centers for Disease Control and Prevention don't list tattooing as a risk factor for hepatitis C. Agency officials recently issued a statement warning the results of the Texas study, and other similar studies might not be applicable to the whole population. The agency is planning its own large-scale study.

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