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Date: Sun, 5 Jan 2003 22:24:37 -0400
Subject: [hepcan] Hep C in saliva #1
HIGH PREVALENCE OF HEPATITIS C VIRUS RNA IN SALIVA OF PATIENTS WITH CHRONIC HCV INFECTION.
Kabil SM, *Salwa M Youssef, Atta MME, **Nawar MA, Abdou SA, Asal A and Nassar AK.
Department of Hepatology, Gastroenterology & Infectious Diseases, University of Benha, *Department of Clinical Pathology, University of Ain Shams and **Department of Tropical Medicine, University of Menoufia, Egypt.
Abstract
In 58 patients with chronic active hepatitis, 38 cases (65.5%) showed positive sera for HCV-RNA by polymerase chain reaction (PCR) and 20 were negative. All patients were screened for the presence of HCV-RNA in saliva by a nested PCR. Among the 38 cases with HCV, 36 were saliva-positive (94.7%) with a 100% specificity. For the same group, second generation ELISA and RIBA testing scored 92.1% and 100% sensitivity, 25% and 70% specificity, respectively. Statistically significant correlation between saliva positivity and histopathological evidence of disease activity was found.
It was concluded that the high prevalence of salivary excretion of the virus might be an attribute of the genotype prevalent in Egypt with profound impact on epidemiological aspects of the disease, particularly the so called community acquired infection. It was also suggested that testing of saliva for HCV infection is a safe, convenient and reliable method of mass screening programs and monitoring of disease activity.
Date: Sun, 5 Jan 2003 22:24:40 -0400
Subject: [hepcan] Hep C in saliva #2
Conference Reports for NATAP
DDW Liver Conference
San Francisco, May 19-22, 2002 Back
HEPATITIS C - TRANSMISSION BY TOOTHBRUSHES: A MYTH OR A REAL POSSIBILITY?
Reported by Jules Levin
Guntram Lock, Martin Dirscherl, Florian Obermeier, Cornelia M. Gelbmann, Claus Hellerbrand, Antje Knoell, Juergen Schoelmerich, Wolfgang Jilg, Regensburg, Germany
Introduction: Up to 40% of patients with chronic hepatitis C have no obvious risk factor for the disease. Unconventional ways of transmission such as for example infection by tattooing or sharing of possibly infected household objects have been discussed to play a role for these community acquired forms. Thus, patients with hep. C are advised to take care not to share objects like razors, nail-scissors or toothbrushes with their household members. In this study, we prospectively examined the contamination of toothbrushes in patients with chronic hep. C as a model for a possible unconventional way of transmission.
Patients and methods: 30 consecutive patients with chronic hep. C were included in the study. Around 2 ml of saliva were obtained before and after brushing the teeth under controlled conditions for 2 minutes. After toothbrushing, the toothbrush was rinsed in 2 ml of NaCl. RNA was isolated with the QIAmp Viral RNA mini Kit (Qiagen) and HCV-RNA was detected by the COBAS AMPLICOR HCV - Test v2.0. Results were qualitatively graded as positive or negative. Oral hygiene was classified as good, fair or bad, and the parodontose bleeding index (PBI) was determined by a dentist. Clinical, biochemical and histological parameters were related to the HCV results in saliva and toothbrush rinsing water.
Results: In 9/30 patients (30%), the "native" saliva (i.e. before toothbrushing) was positive for HCV-RNA, and in 11/29 patients (37.9%) saliva after toothbrushing contained HCV - RNA. In as many as 12/30 (40%) specimen of the rinsing waters of the toothbrushes HCV - RNA was positive. In 6 of these 12 patients, the "native" saliva had been negative for HCV RNA. Patients with HCV - RNA positive toothbrush rinsing water showed no significant differences to patients with HCV RNA negative rinsing water in respect to oral hygiene, PBI, histological grading or staging, coagulation parameters, ALT, bilirubin and quantitative HCV - viral load in the serum.
Conclusion: With sufficiently sensitive methods, a contamination with HCV-RNA can be detected at a large portion of toothbrushes used by hep. C patients. In spite of the low infection risk usually published for household contacts, transmission by contaminated every-day`s household objects appears to be possible. Considering the great epidemiological importance of hep. C, further examinations and maybe even legal instructions concerning publically used possibly infected objects such as razors in barbershops appear indicated.
Date: Sun, 5 Jan 2003 22:24:45 -0400
Subject: [hepcan] Where isn't the hep c virus found???
Status: O
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Biological Hazards
Diseases, Disorders & Injuries
Hepatitis C
What is hepatitis C?
Hepatitis C is an infectious liver disease caused by the hepatitis C virus (HCV). Infections of hepatitis C occur only if the virus is able to enter the blood stream and reach the liver.
For reasons that are not completely understood, about half of all people who develop hepatitis C never fully recover and can carry the virus for the rest of their lives. These people have chronic hepatitis C, and some may eventually develop cirrhosis of the liver and liver failure.
There are other kinds of viral hepatitis such as hepatitis A, hepatitis B, hepatitis D, and hepatitis E. These diseases and the viruses that cause them are not related to hepatitis C even though they also affect the liver. They may have other, different symptoms and different modes of transmission. This means that there are different ways of spreading the disease and different means for preventing and controlling these diseases.
How long does it take for hepatitis C to develop?
The incubation period (the time between initial contact with the virus and the onset of the disease) for hepatitis C ranges from 2 weeks to 6 months, most commonly 6 to 9 weeks.
What are the symptoms of hepatitis C?
The symptoms of hepatitis C infection include fever, nausea and vomiting, loss of appetite, stomach pain, extreme fatigue, and yellowing of the skin and eyes (jaundice).
Some people who are infected with hepatitis C virus have no symptoms and can infect others without knowing it. These persons are at risk of becoming ill at some time in the future. It has been estimated that it may take 10 years to develop symptoms.
How is hepatitis C transmitted?
The hepatitis C virus is spread primarily by exposure to blood. Some people who get hepatitis C do not know how they were infected with the virus.
People may get hepatitis C by sharing needles to inject drugs, or through exposure to blood in the workplace. The risk of getting this virus from a blood transfusion is minimal but still exists. All donated blood is now screened for the hepatitis C virus.
Hepatitis C has been transmitted between sex partners and among household members. However, the degree of this risk still needs to be accurately defined.
There is no evidence that hepatitis C virus is spread by casual contact. Sneezing, coughing and hugging do not pose the risk for hepatitis C. In addition, there is no evidence that hepatitis C virus is spread by food or water.
What occupations have increased risk of hepatitis C?
The risk of acquiring hepatitis C from the workplace depends on the amount of exposure to human blood or blood products and needlestick injuries. In general, occupational groups with increased risk include workers such as dentists, nurses, and laboratory personnel who are repeatedly exposed to human blood and who are at risk of needlestick injuries.
How can we prevent hepatitis C in the workplace?
There is currently no vaccine for hepatitis C. The risk of hepatitis C can be significantly reduced by implementing infection control guidelines suitable for the specific workplace.
Infection control precautions are the first line of defense to protect workers from this virus and other blood-borne diseases. For this reason, the Laboratory Centre for Disease Control at Health Canada and the United States Department of Health and Human Services have developed a uniform approach called "universal precautions."
Originally developed for hospitals, universal precautions have been adapted to a wide range of workplaces. They apply to all situations where workers have risk of exposure to blood or certain body fluids, including
a.. semen
b.. vaginal secretions
c.. synovial fluid
d.. cerebrospinal fluid
e.. pleural fluid
f.. peritoneal fluid
g.. pericardial fluid
h.. amniotic fluid.
Universal precautions do not apply to situations where workers may be exposed to:
a.. feces
b.. nasal secretions
c.. sputum
d.. sweat
e.. tears
f.. urine
g.. vomitus
h.. saliva (except in the dental setting, where saliva is likely to be contaminated with blood).
The purpose of universal precautions is to prevent exposure to blood-borne diseases transmitted by needlestick accidents or fluid contact with an open wound, non-intact skin (e.g., cuts or skin rashes), or mucous membranes. Universal precautions are to be used in conjunction with other control measures. An example is washing hands whenever gloves are removed or whenever the skin contacts potentially infectious fluids.
Universal precautions recommend the use of engineering controls, safe work practices, and personal protective equipment to suit the specific task and workplace. Engineering controls include the use of equipment to isolate or contain the hazard, such as puncture-resistant containers for disposing of used sharps, or biological cabinets for certain procedures in laboratories.
Safe work practices are required for all tasks involving possible exposure to blood or certain body fluids. They include:
a.. safe collection of fluids and tissues for disposal in accordance with local, provincial, territorial, or federal regulations,
b.. safe removal and disposal or decontamination of protective clothing and equipment,
c.. procedures to follow in the event of spills or personal exposures such as needlestick injuries, and
d.. specific and detailed procedures to observe when using and disposing of needles and other sharp objects.
Personal protective equipment provides a barrier to blood and certain body fluids. Equipment recommended by universal precautions include:
a.. gloves to protect the hands and skin,
b.. masks and eye protection together or a face shield to protect mucous membranes of the eye, nose and mouth in any situation where splashes of blood or body fluids may occur, and
c.. aprons to protect clothing from splashes with blood, or gowns if large quantities of blood are present or anticipated.
Additional general information on Universal Precautions is available on this web site.
Date: Sun, 5 Jan 2003 19:35:15 -0800 (PST)
Subject: Re: [hepcan] Hep C in saliva #2
9 out of 30 people had positive saliva before the toothbrushing? Geeze thats scary. Where's this put open mouth kissing then?
Conference Reports for NATAP
DDW Liver Conference
San Francisco, May 19-22, 2002 Back
HEPATITIS C - TRANSMISSION BY TOOTHBRUSHES: A MYTH OR A REAL POSSIBILITY?
Reported by Jules Levin
Guntram Lock, Martin Dirscherl, Florian Obermeier, Cornelia M. Gelbmann, Claus Hellerbrand, Antje Knoell, Juergen Schoelmerich, Wolfgang Jilg, Regensburg, Germany
Introduction: Up to 40% of patients with chronic hepatitis C have no obvious risk factor for the disease. Unconventional ways of transmission such as for example infection by tattooing or sharing of possibly infected household objects have been discussed to play a role for these community acquired forms. Thus, patients with hep. C are advised to take care not to share objects like razors, nail-scissors or toothbrushes with their household members. In this study, we prospectively examined the contamination of toothbrushes in patients with chronic hep. C as a model for a possible unconventional way of transmission.
Patients and methods: 30 consecutive patients with chronic hep. C were included in the study. Around 2 ml of saliva were obtained before and after brushing the teeth under controlled conditions for 2 minutes. After toothbrushing, the toothbrush was rinsed in 2 ml of NaCl. RNA was isolated with the QIAmp Viral RNA mini Kit (Qiagen) and HCV-RNA was detected by the COBAS AMPLICOR HCV - Test v2.0. Results were qualitatively graded as positive or negative. Oral hygiene was classified as good, fair or bad, and the parodontose bleeding index (PBI) was determined by a dentist. Clinical, biochemical and histological parameters were related to the HCV results in saliva and toothbrush rinsing water.
Results: In 9/30 patients (30%), the "native" saliva (i.e. before toothbrushing) was positive for HCV-RNA, and in 11/29 patients (37.9%) saliva after toothbrushing contained HCV - RNA. In as many as 12/30 (40%) specimen of the rinsing waters of the toothbrushes HCV - RNA was positive. In 6 of these 12 patients, the "native" saliva had been negative for HCV RNA. Patients with HCV - RNA positive toothbrush rinsing water showed no significant differences to patients with HCV RNA negative rinsing water in respect to oral hygiene, PBI, histological grading or staging, coagulation parameters, ALT, bilirubin and quantitative HCV - viral load in the serum.
Conclusion: With sufficiently sensitive methods, a contamination with HCV-RNA can be detected at a large portion of toothbrushes used by hep. C patients. In spite of the low infection risk usually published for household contacts, transmission by contaminated every-day`s household objects appears to be possible. Considering the great epidemiological importance of hep. C, further examinations and maybe even legal instructions concerning publically used possibly infected objects such as razors in barbershops appear indicated.
Hepatitis and Health information and news resources
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