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Fiorillo L, Minervini G, Laino L, Peditto M, Cicciù M, Cervino G. Hepatitis-virus-positive patients management in dental office. Minerva Dent Oral Sci 2023; 72:312-318. [PMID: 37255308 DOI: 10.23736/s2724-6329.23.04803-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Hepatitis is a condition characterized by inflammation of the liver, which can be caused by several viruses including hepatitis A, B, C, D and E. This condition can affect the oral health of patients and increase the risk of complications during dental management. The clinical management of hepatitis patients in the dental setting requires a comprehensive and individualized approach to ensure safety and optimal treatment outcomes. This article aims to provide a comprehensive overview of the current literature on the dental management of patients with different forms of hepatitis. METHODS The article focuses on the specific challenges associated with dental treatments in hepatitis patients, including increased risk of infection and bleeding. Additionally, the article provides recommendations for dental practitioners, including infection control measures, communication with medical providers, and the use of prophylactic antibiotics. RESULTS The authors show that the dental management of patients with hepatitis requires a thorough understanding of the specific challenges associated with this condition, as well as the implementation of appropriate preventive measures to ensure the safety and well-being of these patients. CONCLUSIONS Further research is needed to better understand the impact of hepatitis on oral health and the most effective approaches to managing dental treatments in this patient population.
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Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy -
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy -
- Department of Prosthodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, India -
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Matteo Peditto
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Marco Cicciù
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
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Albuquerque-Souza E, Sahingur SE. Periodontitis, chronic liver diseases, and the emerging oral-gut-liver axis. Periodontol 2000 2022; 89:125-141. [PMID: 35244954 PMCID: PMC9314012 DOI: 10.1111/prd.12427] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The liver carries out a wide range of functions ranging from the control of metabolites, nutrient storage, and detoxification to immunosurveillance. While inflammation is essential for the tissue remodeling and maintenance of homeostasis and normal liver physiology, constant exposure to dietary and microbial products creates a niche for potentially prolonged immune activation and unresolved inflammation in susceptible host. Failure to restrain inflammation can lead to development of chronic liver diseases characterized by fibrosis, cirrhosis and eventually liver failure. The liver maintains close interactions with numerous organs which can influence its metabolism and physiology. It is also known that oral cavity microenvironment can influence the physiological conditions of other organs and emerging evidence implicates that this could be true for the liver as well. Presence of chronic inflammation and dysbiotic microbiota is a common feature leading to clinical pathology both in periodontitis and chronic liver diseases (CLDs). In fact, known CLDs appear to have some relationship with periodontitis, which impacts the onset or progression of these conditions in a bidirectional crosstalk. In this review, we explore the emerging association between oral‐gut‐liver axis focusing on periodontitis and common CLDs including nonalcoholic fatty liver disease, chronic viral hepatitis, liver cirrhosis, and hepatocellular cancer. We highlight the immune pathways and oral microbiome interactions which can link oral cavity and liver health and offer perspectives for future research.
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Affiliation(s)
- Emmanuel Albuquerque-Souza
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sinem E Sahingur
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Hooshmand B, Alavian SM, Kouhestani F, Firouzmandi M, Motamedian SR. Detection of Hepatitis C Virus RNA in Blood and Saliva of Transfusion-Dependent Thalassemia Patients Diagnosed with Hepatitis C. Contemp Clin Dent 2018; 9:5-9. [PMID: 29599575 PMCID: PMC5863410 DOI: 10.4103/ccd.ccd_297_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: The aim of the current study was to detect hepatitis C virus (HCV) RNA in blood and saliva of a population of patients with thalassemia who have HCV antibody in their serum. Materials and Methods: In this cross-sectional study, blood and saliva samples were collected and were analyzed with quantitative reverse transcription polymerase chain reaction (RT-PCR) for the detection of HCV RNA. In addition, liver-related blood tests were performed, and patients’ medical history was recorded. Data were analyzed by independent samples t-test and Chi-square with a significant level of 0.05. Results: Overall, 62 adult patients (29 males and 33 females) were included. Most (87%) of the patients had major thalassemia and genotype 1a was the most common (42%) type. HCV RNA was detected in 71 and 16% of blood and saliva samples, respectively. HCV RNA was detected more in female patients (31%) (P = 0.003) and in intermediate thalassemia (50%) (P < 0.005). The mean age of the patients with positive saliva was almost 10 years older (P < 0.001), and the mean number of blood transfusion was fewer in positive saliva group (P = 0.037). The sensitivity, specificity, and positive and negative predictive values of saliva PCR was calculated to be 18%, 88%, 80%, and 69%, respectively. Conclusion: Saliva contained HCV RNA in 16% of the assessed population. The probability of detection of HCV RNA in saliva increased in older patients, less number of blood transfusions, females and intermediate thalassemia. Saliva RT-PCR demonstrated low sensitivity and high specificity with high positive predictive value in the assessed population.
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Affiliation(s)
- Behzad Hooshmand
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Farnaz Kouhestani
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Firouzmandi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Reza Motamedian
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hepatitis C Infection and Periodontal Disease: Is there a Common Immunological Link? J Immunol Res 2018; 2018:8720101. [PMID: 29725605 PMCID: PMC5872607 DOI: 10.1155/2018/8720101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/31/2017] [Accepted: 01/03/2018] [Indexed: 02/07/2023] Open
Abstract
Hepatitis C virus (HCV) infections could have an important impact on the oral health status of patients, favoring conditions such as periodontal disease and oral cancer. The review of the existing scientific literature written in English was performed, searching for oral and periodontal manifestations of HCV infection and its impact on the oral fluids. HCV infection can determine direct extrahepatic manifestations at the oral and periodontal level including oral lichen planus, Sjögren-like sialadenitis, and oral cancer. The changes caused by the infection in the subjects' immune system, diet, and lifestyle can facilitate the development of oral conditions such as periodontal disease. Important changes also occur in the composition of the infected patients' saliva and gingival fluid. HCV-infected patients need to be carefully monitored in terms of oral health since the infection with the virus can result in oral complications. The cellular and molecular particularities of the gingival fluid of HCV-infected patients can answer some questions regarding its impact upon periodontium impairment and whether this refers to a possible bidirectional relationship, with hepatic biomarker adjustments being induced by the periodontal patients' inflammatory status.
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Abstract
BACKGROUND There is a gap in the scientific literature about the association between oral health and the health-related quality of life of patients on the liver transplantation waiting list. The aim of this work was to describe aspects of oral health and quality of life of patients on a liver transplantation waiting list. METHODS This was a cross-sectional study among 116 patients with chronic hepatic disease: 29 on a liver transplantation waiting list (Model for End-Stage Liver Disease score ≥15) and 87 under monitoring in a gastroenterology service in a Brazilian university hospital. Oral health was evaluated according to criteria recommended by the World Health Organization and by the European Association of Dental Public Health. Health-related quality of life was evaluated by means of the 36-Item Short-Form Health Survey (SF-36). RESULTS Patients on the liver transplantation waiting list presented poorer health-related quality of life than those who were not on the list in the domains physical functioning, role physical, bodily pain, general health perceptions, and social functioning and in the physical component summary. Periodontitis affected 72.4% of the patients on the liver transplantation waiting list, but only 27.6% of the patients not on that list. Reduced salivary flow was associated with poorer mental health component summary in hepatitis C patients. CONCLUSIONS Patients on the liver transplantation waiting list presented poorer health-related quality of life than those who were not on the list, mainly in the indicators concerning physical health, as well as higher frequencies of decayed teeth and periodontitis. The mental health component summary was associated with reduced salivary flow in hepatitis C patients.
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Evaluation of viral load in saliva from patients with chronic hepatitis C infection. J Infect Public Health 2015; 8:474-80. [PMID: 26044945 DOI: 10.1016/j.jiph.2015.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 03/26/2015] [Accepted: 04/03/2015] [Indexed: 11/22/2022] Open
Abstract
Hepatitis C virus can be detected in blood and other bodily fluids, such as saliva. The aim of this study was to detect and quantify the HCV-RNA in saliva and plasma from patients with chronic hepatitis C infections, as well as check the level of viral load in sex groups (age, ethnicity and virus subtypes). Whole saliva and blood from 70 patients with chronic hepatitis C infections attended at the department of gastroenterology from University Hospital. The HCV-RNA load was performed by qRT-PCR using Sybr Green I master mix. HCV-RNA was detected in 80% (56/70) of patients in saliva and 92.85% (65/70) in plasma. The median of the viral load in the plasma was of 4.87 log10, and in saliva, it was 3.32log10, (p = 0.0005). Female patients and black patients exhibited a negative correlation between the HCV-RNA load in saliva vs. the HCV-RNA load in plasma (r = -0.3172, CI95% -0.6240 to -0.03736, p = 0.0491) and (r = -0.3141; IC95% -0.6069 to -0.05926; p = 0.0209), respectively. HCV-RNA was detected and quantified in saliva samples, and according to the quantification levels, saliva may be a possible transmission source of HCV, particularly in women and people of black ethnicity who develop chronic HCV infections.
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Greenman J, Roberts T, Cohn J, Messac L. Dried blood spot in the genotyping, quantification and storage of HCV RNA: a systematic literature review. J Viral Hepat 2015; 22:353-61. [PMID: 25367722 PMCID: PMC4409077 DOI: 10.1111/jvh.12345] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 09/09/2014] [Indexed: 12/12/2022]
Abstract
The entry of new all-oral direct acting antiviral therapy for hepatitis C provides an opportunity to scale up HCV care in low- and middle-income countries. In HIV, use of dried blood spots (DBS) has facilitated the diagnosis and management of HIV in resource-poor settings. DBS may be used in a similar way to facilitate diagnosis and management of HCV. Here, we present a systematic review of the literature of DBS for HCV RNA detection and genotyping. Using an a priori review protocol, three databases were searched for studies published up to August 2013 that reported the use of dried blood and serum spots in genotyping, detection and measurement of HCV RNA, as well as the rate of degradation of HCV RNA when stored in DBS at room temperature. Nine papers were eligible for inclusion; eight studied DBS and one dried serum. Two studies measured concordance between genotype and subtype determined by DBS and whole plasma and both found 100% concordance. Four studies measured endpoint detection limits of HCV RNA-positive samples by DBS and found positive predictive values of 100% down to 250, 334, 2500 and 24160 IU/mL. Two studies found deterioration of HCV RNA in DBS samples stored at room temperature, while two others failed to detect such deterioration. These results support the potential use of DBS for genotyping and HCV RNA detection. Studies of the use of DBS for HCV RNA viral load measurement and of the rate of degradation of HCV RNA when stored in DBS at ambient temperatures remain inconclusive.
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Affiliation(s)
- Jamie Greenman
- Department of Medicine, Hospital of the University of PennsylvaniaPhiladelphia, PA, USA
| | - Teri Roberts
- Access Campaign, Médecins Sans FrontièresGeneva, Switzerland
| | - Jennifer Cohn
- Department of Medicine, Hospital of the University of PennsylvaniaPhiladelphia, PA, USA
- Access Campaign, Médecins Sans FrontièresGeneva, Switzerland
| | - Luke Messac
- Perelman School of Medicine, University of PennsylvaniaPhiladelphia, PA, USA
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Sosa-Jurado F, Hernández-Galindo VL, Meléndez-Mena D, Mendoza-Torres MA, Martínez-Arroniz FJ, Vallejo-Ruiz V, Reyes-Leyva J, Santos-López G. Detection of hepatitis C virus RNA in saliva of patients with active infection not associated with periodontal or liver disease severity. BMC Infect Dis 2014; 14:72. [PMID: 24512371 PMCID: PMC3925132 DOI: 10.1186/1471-2334-14-72] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 02/03/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) is mainly transmitted by parenteral route, being blood transfusion and intravenous drug use the most frequent risk factors. However, it has been suggested that there are other routes of transmission. There are several studies where HCV RNA has been detected in saliva of patients infected with HCV, and epidemiological studies have proposed the dental treatments as possible risk factors for HCV transmission. The purpose of this study was to detect the presence of HCV RNA in saliva of patients with active infection and associating with periodontal or liver disease. METHODS Patients with quantifiable HCV-RNA in serum were enrolled in the study. Periodontal disease was assessed using the modified gingival index (MGI). Presence of dental plaque was assessed with the use of disclosing tablets. Patients were clinically and laboratory evaluated to identify the stage of liver disease, the HCV RNA was determinate in saliva by nested RT-PCR. To determine associations between different parameters univariate and multivariate analysis were used. RESULTS A total of 45 patients were included. Of these patients, 21 (46.6%) had hepatitis, 23 (51.1%) had cirrhosis and one patient (2.4%) presented hepatocellular carcinoma (HCC). Viral loads in serum ranged from 2.31-6.68 log IU/ml with a mean of 5.46 log IU/ml (95% CI 5.23-5.70). HCV RNA was positive in saliva of 29 patients (64.4%) and was not detected in 16 (35.6%). For univariate analysis three independent variables were associated with the detection of HCV-RNA in saliva: gender, viral load and dental plaque and multivariate analysis only one independent variable viral load >5.17 log IU/mL remained significantly associated with the detection of HCV in saliva (p = 0.0002). A statistical difference was observed when viral load was analyzed, log 5.85 IU/mL (95% CI 5.67-6.02) for patients with HCV in saliva vs. log 4.77 IU/mL (95% CI 4.35-5.19) for patients without HCV in saliva (p = 0.0001). The detection of HCV-RNA in saliva was more frequent in patients with relatively high serum viral loads. CONCLUSION HCV-RNA in saliva was associated with the level of serum viral load but not with periodontal or liver disease severity.
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Affiliation(s)
- Francisca Sosa-Jurado
- Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Km 4.5 Carretera Federal Atlixco-Metepec, Metepec, Puebla CP 74360, México
| | - Verónica L Hernández-Galindo
- Maestría en Ciencias en Investigación Clínica, Escuela Superior de Medicina y Homeopatía, Instituto Politécnico Nacional, Distrito Federal, México
| | - Daniel Meléndez-Mena
- Servicio de Gastroenterología, Hospital de Especialidades, Unidad Médica de Alta Especialidad, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, Puebla, México
| | - Miguel A Mendoza-Torres
- Servicio de Gastroenterología, Hospital de Especialidades, Unidad Médica de Alta Especialidad, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, Puebla, México
| | | | - Verónica Vallejo-Ruiz
- Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Km 4.5 Carretera Federal Atlixco-Metepec, Metepec, Puebla CP 74360, México
| | - Julio Reyes-Leyva
- Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Km 4.5 Carretera Federal Atlixco-Metepec, Metepec, Puebla CP 74360, México
| | - Gerardo Santos-López
- Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Km 4.5 Carretera Federal Atlixco-Metepec, Metepec, Puebla CP 74360, México
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Amado Leon LA. Saliva specimen sampling: a noninvasive method for diagnosis and basic investigation of viral hepatitis A, B and C. Future Virol 2013. [DOI: 10.2217/fvl.13.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Saliva is a biological fluid that is easy to collect and manipulate. Collection of saliva samples is less expensive, noninvasive and painless compared with blood collection. Due to these advantages, saliva has been investigated as an alternative fluid to serum for diagnostic and epidemiological purposes. The aim of this article was to the review research on salivary biomarkers of viral hepatitis A, B and C, highlighting their current use, collection devices, and potential applications for diagnosis and epidemiological studies. This paper also explores recent findings of saliva as a possible source of viral hepatitis transmission.
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Affiliation(s)
- Luciane Almeida Amado Leon
- Laboratory of Technological Development in Virology, Institute Oswaldo Cruz – Fiocruz, Av. Brasil 4365, Rio de Janeiro, 21045-900, Brazil
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Menezes GBL, Pereira FA, Duarte CAB, Carmo TMA, Silva Filho HPD, Zarife MA, Krieger MA, Reis EAG, Reis MG. Hepatitis C virus quantification in serum and saliva of HCV-infected patients. Mem Inst Oswaldo Cruz 2013; 107:680-3. [PMID: 22850960 DOI: 10.1590/s0074-02762012000500016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 04/12/2012] [Indexed: 12/17/2022] Open
Abstract
The hepatitis C virus (HCV) can be detected in blood and other bodily fluids, such as saliva, semen and gastric juices. The aim of this study was to compare the HCV viral loads in the serum and saliva of infected patients. Twenty-nine patients with detectable HCV RNA in their serum and saliva were included in this study. The HCV viral loads were determined through quantitative real-time polymerase chain reactions. The median viral RNA levels were 5.78 log10 copies in the serum and 3.32 log10 copies in the saliva. We observed that the salivary HCV viral load was significantly lower than the viral load in the serum. Further studies are required to understand the role of saliva in the diagnosis, management and potential transmission of HCV.
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Fábryová H, Celec P. On the origin and diagnostic use of salivary RNA. Oral Dis 2013; 20:146-52. [PMID: 23517132 DOI: 10.1111/odi.12098] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 02/23/2013] [Accepted: 02/24/2013] [Indexed: 01/09/2023]
Abstract
Saliva as a diagnostic fluid enables non-invasive sampling, which can be performed even by an untrained person. Saliva is, thus, particularly useful for large population screenings, for children, elderly and whenever repeated samplings are needed. Saliva is a plasma filtrate actively modified by the salivary glands. Saliva could replace some routine blood tests in the future. The sources of salivary RNA include oral epithelial cells and oral micro-organisms. Recent developments suggest that using known salivary RNA markers, it is possible to diagnose diseases such as oral carcinoma and other diseases will be added soon. Salivary RNA can be used to identify oral bacteria and to determine the expression of specific genes. On a systemic level, it provides information about the whole oral transcriptome and microbiome. Despite the small amount of salivary RNA, the issues with its isolation have been overcome. Saliva, thus, contains RNA of sufficient quality and quantity for sensitive and specific analyses. Salivary RNA can provide medically relevant information about oral microbiome, oral carcinoma, but also breast and pancreatic cancer and is, thus, a promising tool for future research and clinical diagnostics.
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Affiliation(s)
- H Fábryová
- Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia
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Su FH, Chang SN, Chen PC, Sung FC, Huang SF, Chiou HY, Su CT, Lin CC, Yeh CC. Positive association between hepatitis C infection and oral cavity cancer: a nationwide population-based cohort study in Taiwan. PLoS One 2012; 7:e48109. [PMID: 23133554 PMCID: PMC3485043 DOI: 10.1371/journal.pone.0048109] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 09/19/2012] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The association between viral hepatitis (B and C) and oral cavity cancer has been widely debated. This nationwide, population-based cohort study assessed the subsequent risk of oral cavity cancer among patients with chronic viral hepatitis infection. MATERIALS AND METHODS Data were retrieved from insurance claims data of 1,000,000 randomly sampled individuals covered under the Taiwan National Health Insurance system. We identified a total of 21,199 adults with chronic viral hepatitis infection (12,369 with HBV alone, 5,311 with HCV alone, and 3,519 with HBV/HCV dual infections) from 2000-2005. Comparison group comprised 84,796 sex- and age-matched subjects without viral hepatitis during the same study period. Incidence and risk of subsequent oral cavity cancer were measured until 2008. RESULTS The incidence of oral cavity cancers was 2.28-fold higher among patients with HCV alone than non-viral hepatitis group (6.15 versus 2.69 per 10,000 person-years). After adjusting for sociodemographic covariates, HCV alone was significantly associated with an increased risk for oral cavity cancer (hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 1.20-3.02). This positive association was highest among individuals in the 40-49-year age group (HR = 2.57, 95% CI = 1.21-5.46). However, there were no significant associations between HBV alone or HBV/HCV dual infections and risk for oral cavity cancer. CONCLUSION Our data suggest that HCV but not HBV infection is a risk factor for oral cavity cancer. In addition, subjects with HCV infection tend to be at early onset risk for oral cavity cancer. This finding needs to be replicated in further studies.
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Affiliation(s)
- Fu-Hsiung Su
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shih-Ni Chang
- The Ph.D. Program for Cancer Biology and Drug Discovery, China Medical University, Taichung, Taiwan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Pei-Chun Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Shiang-Fu Huang
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Tao-Yuan, Taiwan
| | - Hung-Yi Chiou
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
- Center of Excellence for Cancer Research, Taipei Medical University, Taipei, Taiwan
| | - Chien-Tien Su
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan
| | - Chih-Ching Yeh
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
- * E-mail:
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Bennett S, Gunson RN, McAllister GE, Hutchinson SJ, Goldberg DJ, Cameron SO, Carman WF. Detection of hepatitis C virus RNA in dried blood spots. J Clin Virol 2012; 54:106-9. [PMID: 22418454 DOI: 10.1016/j.jcv.2012.02.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 02/06/2012] [Accepted: 02/08/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND An estimated 130-170 million people worldwide are chronically infected with HCV.(1) In Europe the highest prevalence of HCV infections is in the IDU population.(2) As traditional HCV screening relies on the detection of HCV antibody or HCV RNA in blood, screening in high-risk groups such as IDU is difficult due to poor venous access caused by damaged veins. OBJECTIVES In this study DBS was evaluated as an alternative sample type to blood for the detection of HCV RNA. STUDY DESIGN The endpoint detection limit, inter-assay and intra-assay variability of the method were determined. The DBS method was compared to our routine frontline assay using a panel of paired DBS and blood samples. The effect of different storage temperatures and length of storage time on the stability of HCV RNA in DBS was also assessed. RESULTS The endpoint detection limit of the method based on results from mock DBS was 250 IU/ml. The method was shown to be precise and robust. The sensitivity and specificity of the method was found to be 100% and 95.8%, respectively. No significant variation in the stability of HCV RNA in DBS over a 1 year period at a range of different temperatures was observed. CONCLUSIONS A sensitive and stable method was developed for the detection of HCV RNA in DBS. Screening high-risk populations using DBS as a sample type may improve uptake of HCV testing by increasing opportunity for patients to be tested and consequently increasing access to treatment.
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Affiliation(s)
- Susan Bennett
- West of Scotland Specialist Virology Centre, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK.
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El Tayeb H, El Nakeeb NA, Sayed MM, Yousry WA, Agwa SH. Pilot study for assessment of prevalence of intrafamilial hepatitis C transmission in relation to salivary viral load among infected patients with and without chronic renal failure. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2012. [DOI: 10.1016/j.ejmhg.2011.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Mahboobi N, Porter SR, Karayiannis P, Alavian SM. Oral fluid and hepatitis A, B and C: a literature review. J Oral Pathol Med 2011; 41:505-16. [PMID: 22188507 DOI: 10.1111/j.1600-0714.2011.01123.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Viral hepatitis is a significant global health problem that, depending upon the virus, affects individuals of the developing and/or developed world. In recent years, there has been renewed interest in whether oral fluids can be considered as a source of viral hepatitis transmission and whether oral fluid, in particular, whole saliva, may be a useful source for viral detection as part of the diagnosis and monitoring of viral hepatitis. The aim of this article was to review current data concerning the possible carriage of the hepatitis A, B and C viruses within saliva and gingival crevicular fluid. Such knowledge will indicate if (i) oral fluid is a possible source of infection and (ii) whether oral fluid can be used for diagnosis and monitoring of viral hepatitis. DATA AND SOURCES A literature search was conducted using PubMed (Medline), EMBASE/Excerpta medica, the Cochrane database and Scopus. The results were limited to published material after 2000. Relevant material was evaluated and reviewed. CONCLUSION There is some evidence that hepatitis viruses A, B and C are present in oral fluids, particularly whole saliva and gingival crevicular fluid and may thus be possible sources of viral detection in clinical diagnosis and monitoring. However, the data are inconsistent and warrant the need for well-planned longitudinal studies to explore the precise frequency of oral carriage of such viruses and to determine the virological and host factors that may influence the oral presence of hepatitis A, B and C viruses.
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Affiliation(s)
- Nima Mahboobi
- Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran
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Detection of HCV RNA in saliva does not correlate with salivary flow or xerostomia in patients with chronic hepatitis C. ACTA ACUST UNITED AC 2010; 109:851-6. [DOI: 10.1016/j.tripleo.2010.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 02/02/2010] [Accepted: 02/13/2010] [Indexed: 01/17/2023]
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Correlation of hepatitis C antibody levels in gingival crevicular fluid and saliva of hepatitis C seropositive hemodialysis patients. Int J Dent 2009; 2009:247121. [PMID: 20309410 PMCID: PMC2837414 DOI: 10.1155/2009/247121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 07/04/2009] [Accepted: 08/03/2009] [Indexed: 01/21/2023] Open
Abstract
Search for hepatitis C virus (HCV) in body fluids other than blood is important when assessing possible nonparenteral routes of viral transmission. However, the role of oral fluids in HCV transmission remains controversial. Our aim was to compare the prevalence of HCV antibody (HCV Ab) levels in saliva, and gingival crevicular fluid (GCF) of HCV seropositive hemodialysis patients. Serum, saliva and GCF samples were collected from thirty-nine patients. Samples were analyzed for HCV Ab using the Ortho HCV 3.0 SAVe enzyme-linked immunosorbent assay (ELISA). HCH Ab levels in saliva and GCF of all HCV-seropositive patients were statistically compared. Reported here are the results of the study designed to determine the correlation between HCV-RNA positivity in serum and the detection of antibodies in GCF and saliva. One hundred percent (100%) of the 39 patients have antibodies to HCV in their serum, 15.4% have antibodies to HCV in GCF, and saliva found out. HCV Ab seropositivity in GCF and saliva was significantly correlated (kappa = 0.462; P < .001). This study supports the concept that GCF may be a significant source of HCV in saliva.
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Kasman LM, London LL, London SD, Pilgrim MJ. A mouse model linking viral hepatitis and salivary gland dysfunction. Oral Dis 2009; 15:587-95. [PMID: 19656314 DOI: 10.1111/j.1601-0825.2009.01600.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Viral hepatitis is known to cause xerostomia in humans, but this has not been reported in an animal model. We report a severe, acute, highly reproducible saliva deficiency occurring in BALB/c mice as a result of experimental viral hepatitis. MATERIALS AND METHODS BALB/c mice, splenectomized or carrying genetic mutations to detect immunological contributions to the saliva deficiency syndrome, were infected intraperitoneally with a non-lethal dose of murine cytomegalovirus. Pilocarpine-stimulated saliva volumes were determined between 0 and 15 days after infection. Salivary gland, liver, spleen, and sera were analyzed for the presence of virus, cytokines, inflammatory infiltrates, and tissue damage. RESULTS Saliva deficiency was detectable 2 days after cytomegalovirus infection, peaked at 88% below normal by day 7, and resolved partially in all mice by 15 days postinfection as sialoadenitis increased. Neither salivary gland viral titers, sialoadenitis, splenectomy, nor systemic inflammatory markers correlated with hyposalivation severity. Elevated liver enzymes did correlate with hyposalivation, and mice genetically resistant to murine cytomegalovirus-induced hepatitis were significantly protected. CONCLUSIONS Murine cytomegalovirus-induced salivary gland dysfunction is biphasic, with an acute hepatitis-associated phase and a later sialoadenitis-associated phase. Acute murine cytomegalovirus infection of BALB/c mice may provide a model for investigation of hepatitis-associated xerostomia.
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Affiliation(s)
- L M Kasman
- Department of Microbiology and Immunology, Medical University of South Carolina, BSB-201, PO Box 250504, 173 Ashley Ave, Charleston, SC 29403, USA.
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Raggam RB, Wagner J, Michelin BDA, Putz-Bankuti C, Lackner A, Bozic M, Stauber RE, Santner BI, Marth E, Kessler HH. Reliable detection and quantitation of viral nucleic acids in oral fluid: Liquid phase-based sample collection in conjunction with automated and standardized molecular assays. J Med Virol 2008; 80:1684-8. [DOI: 10.1002/jmv.21245] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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