The mean prevalence of anti-hepatitis C virus (HCV) in Italy is 0.87%. It reaches 2% in Campania, Southern Italy. Approximately 50% of community acquired non-A, non-B (NANB) hepatitis cannot be associated with known parenteral exposure. A recent Italian study has shown that the only demonstrable risk factor in 9% of acute C/NANB hepatitis is dental treatment. There are no data on direct contamination by HCV of dental surgeries. Possible environmental contamination by HCV-RNA was investigated in dental surgeries after treatment of anti-HCV and HCV-RNA positive patients. Thirty-five anti-HCV and HCV-RNA positive patients with chronic hepatitis underwent dental treatment and were enrolled in this study. Eight had chronic persistent hepatitis (CPH), 23 chronic active hepatitis (CAH), and 4 cirrhosis. A total of 328 samples collected from instruments and surfaces were tested after dental treatment of 35 anti-HCV positive patients. The presence of HCV-RNA was determined by polymerase chain reaction (PCR) to evaluate contamination of instruments and surfaces in dental surgeries. Twenty (6.1%) out of 328 collected samples were positive for HCV-RNA. The positive samples were from work benches (two), air turbine handpieces (one), holders (four), suction units (one), forceps (four), dental mirrors (two), and burs (six). Our data indicate that there is extensive contamination by HCV of dental surgeries after treatment of anti-HCV patients and that if sterilisation and disinfection are inadequate there is the possible risk of transmission to susceptible individuals.
The presence and concentration of haemoglobin in saliva of anti-human immunodeficiency virus (HIV) positive subjects, anti-HIV-negative subjects at high risk of infection, and healthy controls were studied. One hundred eighty-eight subjects were anti-HIV-positive intravenous drug abusers (IVDA), 22 were anti-HIV-positive homosexual men, 23 were anti-HIV-positive heterosexual contacts, 132 were anti-HIV-negative IVDA, 35 were anti-HIV-negative homosexual men, and 154 were healthy controls. Two milliliters of saliva was collected in the morning before brushing teeth, and the presence and the concentration of haemoglobin were determined. Based on hemoglobin, the data show that the anti-HIV-positive IVDA have the highest tendency to bleeding. The difference between this group with respect to anti-HIV-negative IVDA (P < 0.05) and compared with healthy controls (P < 0.01) is statistically significant. This is also true of anti-HIV-positive heterosexual contacts with respect to healthy controls (P < 0.01). Our data show that all at-risk groups, both anti-HIV positive and anti-HIV negative, have higher haemoglobin concentration than the control group; this difference reaches statistical significance only between anti-HIV-positive IVDA and controls (P < 0.01). The concentration of haemoglobin is significantly higher in subjects with CD4+ lymphocytes < 200/mm3 compared to subjects with CD4+ lymphocytes > 200/mm3 (P < 0.01), in subjects with AIDS-related complex (ARC)/AIDS compared to asymptomatic/PGL subjects (P < 0.01), and in subjects with stomatitis compared to subjects without stomatitis (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
4 Ross GD, Thompson RA, Walport MJ, et al. Characterization of patients with an increased susceptibility to bacterial infections, and a genetic deficiency of leukocyte membrane complement receptor type 3 and the related membrane antigen LFA-1. Blood 1985;66:882-90.
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