Non-A non-B hepatitis--quandaries in serological testing and treatment

Presence of anti-hepatitis C virus serum markers in a dental school patient population

Hepatitis C virus (HCV) has joined the list of infections liver diseases of which the practicing dentist must be aware. This recently described RNA virus causes between 20% to 40% of reported cases of viral hepatitis in the United States. Patients with HCV show symptoms only one quarter of the time, but chronicity is maintained longer than with the other liver infections. The major mode of transmission is percutaneous, so dentists are potentially at risk to contact the virus. To assess the presence of exposure to HCV, a total of 500 dental school patients were screened for serum antibody to this virus (second-generation anti-HCV). In addition, participants were required to fill out a special screening questionnaire designed to indicate high-risk groups. Their serum was also analyzed for serum chemistries known to be associated with acute and chronic liver disease. Analysis of the 15 response questionnaires revealed statistical significance relating to questions inquiring about previous exposure to blood (transfusions, surgical procedures, etc) but little significance relating to lifestyle. In either case responses were not of practical predictive value. More than 5% of our sample patients were found to be positive reactors to anti-HCV, indicating previous HCV exposure. A significant number of those positive for anti-HCV also showed elevation of serum chemistries associated with hepatitis.

Intrafamilial transmission of hepatitis C virus (HCV): a major mode of spread in the Saudi Arabia population

Age-specific prevalence of antibody to hepatitis C virus (anti-HCV) was studied in 831 Saudis (441 males, 390 females; 1-53 years old) from Al Baha region, south-west Saudi Arabia. There was a gradual exposure to HCV early in life with a gradual increase with age, reaching a peak of 5.3% in the 30-40 years age group. The overall prevalence was 3.6% and 3.1% in males and females, respectively, with no statistical difference. Comparison of positivity in family members of seven anti-HCV-positive index cases (15/44) with those of five anti-HCV-negative index cases (2/44) showed a statistically significant association (chi 2 10.5 with Yates' correction). This points to intrafamilial transmission of HCV as a route of spread among the Saudi population.