Oral fluids as risk factors for intrafamilial transmission of hepatitis C virus

ABSTRACT

To evaluate the frequency of hepatitis C virus [HCV] infection among the family members of chronically infected HCV patients, to investigate the oral cavity fluids as a possible risk factor for transmission of HCV infection, to asses the reliability of gingival crevicular fluid [GCF] and saliva anti-HCV [HCVAb] and HCV-RNA testing for detection of HCV and to study the oral mucosa and periodontal condition of HCV infected subjects. Serum, GCF and saliva specimens were obtained from 19 index cases with chronic HCV and their relatives [n = 83] to detect HCVAb by ELISA and HCV-RNA by a modified commercial polymerase chain reaction [PCR] assay. The clinical oral mucosal and periodontal conditions were evaluated. HCV infection was detected in the relatives of 17 out of 19 families. The newly diagnosed cases were 41%, of them 66.7% were parents, 34.6% brothers and 4.8% sisters. The intrafamilial frequency of positive anti-HCV was 60.8%, 47.1% and 38.2% in the serum, GCF and saliva specimens respectively of the total studied population. HCV-RNA was detected in 52%, 41.2% and 28.4% in the same body fluids in order of frequency. The sensitivity and specificity for anti-HCV in the serum, GCF and saliva were 100%, 90.6%, 71.7% and 81.6%, 100%, 98% respectively. The corresponding values for HCV-RNA were 100%, 79.2%, 54.7% and 100%, 100%, 100% respectively. Strong positive associations were found between serum PCR and anti-HCV testing in serum, GCF, saliva and HCV-RNA testing in GCF and saliva [P<0.001]. No significant difference was found regarding mucosal and periodontal clinical evaluation between HCV positive and negative persons. It was concluded that [1] The relatives of HCV infected patients are at risk to acquire the disease. [2] GCF and saliva presented detectable levels of anti-HCV and HCV-RNA, which might be sources of HCV infection among family members. [3] Detectable levels of GCF and saliva anti-HCV and HCV-RNA may be of diagnostic value in HCV infection. [4] No correlation was found between oral mucosa and periodontal condition and HCV infection