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Anyone who received injections at the Tri-County Spinal Care Center should be tested for HIV, hepatitis B and hepatitis C, the state health department said Wednesday, because “several lapses in infection control procedures” were found at the North Charleston clinic.

Cheryl Smithem, of Charleston PR & Design, speaking on behalf of the clinic, said about 500 patients received injections there since September 2011, when they were first offered.

The S.C. Department of Health and Environmental Control is investigating the facility for a recent string of hepatitis B cases.

Three patients who received injections at the Dorchester Road facility in February recently tested positive for the disease. No positive tests for hepatitis C or HIV have been reported, and the investigation is ongoing, DHEC spokesman Jim Beasley confirmed.

Last week, DHEC notified more than 20 Tri-County Spinal Care Center patients who also received injections in February that they should be tested for hepatitis B. The department said it was expanding the scope of the investigation to include all patients who received injections of any kind, including IV fluids, at the center in the past 21 months.

“It was determined that procedures may have been performed that resulted in a potential for exposure to an infection,” a DHEC press release said. “Since the clinic’s injection practices have not changed since they began offering injections in September 2011, DHEC cannot ensure that patients who received injections at any time since then were not exposed to a blood-borne pathogen.”

DHEC also ordered the clinic to stop performing all invasive procedures.

A message left for Tri-County Spinal Care Center owner Cameron Wills, a chiropractor, was not returned Wednesday, but he issued a statement through the public relations firm.

“We have always used sterile, single-use supplies for injections. We do not reuse syringes or needles,” Wills said.

Dr. Cassy Salgado, an associate professor for infectious disease at the Medical University of South Carolina, said hepatitis B and hepatitis C are blood-borne diseases caused by two different viruses. In some cases, hepatitis B and hepatitis C clear on their own. In other cases, the diseases can develop into chronic conditions and cause liver cancer.

HIV is an incurable, blood-borne pathogen, she said.

“All of those can be transmitted the same way,” Salgado said. “If you’re exposed in a way that would permit hepatitis B to be transmitted, it means you were exposed in a way that would allow hepatitis C and HIV to be transmitted.”

Reach Lauren Sausser at 937-5598.