口腔科器械乙肝病毒消毒测试报告

为了解我科医疗器械目前采取的消毒方法对乙型肝炎病毒消毒的安全性、可靠性,我们对本科５种常用器械进行了乙型肝炎病毒表面抗原（ＨＢｓＡｇ）和ｅ抗原（ＨＢｅＡｇ）的消毒测试,结果如下。材料及方法１．调查对象：选择５套一次性口镜、镊子、探针和５颗车针,将器械...     

口腔糜烂型扁平苔藓与慢性肝病的临床研究

本研究对３２例口腔糜烂型扁平苔藓患者的肝酶学及病原学进行检测，结果发现，有７例患者（２１．８８％）的血清谷丙转氨酶（ＡＬＴ）和／或血清谷草转氨酶（ＡＳＴ）值升高，且这７例患者中有５例ＨＢｓＡｇ、ＨＢｅＡｇ和抗ＨＢＣ阳性。另有１例患者ＨＢｓＡｇ、ＨＢｅＡｇ和ＨＢＣ阳性。２例患者抗ＨＣＶ阳性，而血清酶水平未见升高。本研究提示对口腔糜烂型扁平苔藓患者，除应注意询问相关病史外，还就常规进行功能和肝炎病毒检     

污染HBsAg的口腔器械消毒方法的实验研究

目的：探讨一种能在较短时间内灭活ＨＢＶ的消毒方法。方法：采用不同浓度的戊二醛擦拭消毒已污染ＨＢｓＡｇ阳性血清的口腔专科常用诊疗器械,用ＥＬＩＳＡ法检测ＨＢｓＡｇ。结果：用２０～３０ｍｌ／Ｌ戊二醛消毒剂擦拭消毒１遍已污染ＨＢｓＡｇ的口腔器械,ＨＢｓＡｇ的灭活率为８％,而采用擦拭消毒３遍的方法,ＨＢｓＡｇ的灭活率为９２％～１００％。结论：选用较高浓度的戊二醛消毒剂擦拭消毒３遍,可以达到灭活ＨＢｓＡｇ的目的。     

30例住院患者HBsAg,HBeAg,抗HBC测定结果的报告

３０例住院患者ＨＢｓＡｇ、ＨＢｅＡｇ、抗ＨＢＣ测定结果的报告首都医学院附属北京口腔医院检验科郝世雄，丁利乙型肝炎病毒（ＨＢＶ）既可造成急性，也可造成慢性肝炎。由于乙型肝炎发病率高，传染性强，在口腔颌面外科病房的治疗及护理工作中，加强消毒隔离，防止ＨＢ...     

SCD消毒剂浸泡消毒口腔器械的实验研究

笔者选用近年来国内外已开始应用于医学临床的广谱高效消毒剂ＳＣＤ ,并用已污染ＨＢｓＡｇ阳性血清的 6种口腔常用治疗器械进行消毒的实验观察。一、材料和方法1.器械 :机头、口镜、牙钳、镊子、探针、弯盘 ;中和剂ＰＢＳ缓冲液 ;酶标仪ＳＴＬ(ＡＵＳＴＲＩＡ) ;ＨＢｓＡｇ试剂盒 (厦门新创 )。2 .污染ＨＢｓＡｇ的载体制备 :将载体放入装有 10 0ｍｌＨＢｓＡｇ阳性血清 (效价 1:10 0 0 )的烧杯中 ,放置 37 Ｃ温箱内45ｍｉｎ ,取出后待消毒。3.污染ＨＢｓＡｇ载体的消毒 :消毒剂为ＳＣＤ ,浓度为5 0 0ＰＰＭ、10 0 0ＰＰＭ、2 0 0 0ＰＰＭ …     

丙型肝炎病毒感染与口腔粘膜扁平苔藓关系的初探

目的 本研究对４０例口腔扁平苔藓（ＯＬＰ）患者及４０名对照组患者分别用于干湿全自动生化分析仪,酶链免疫吸附试验（ＥＬＺＳＡ）及多聚酶链反应（ＰＣＲ）检测外周血ＡＬＴ,抗－ＣＨＶ物ＨＣＶ－ＲＮＡ,以探讨ＨＣＶ感染与ＯＬＰ之间的关系。结果 ４０名ＯＬＰ患者中,１０例（２５．０％）有ＡＬＴ异常,８例（２０．０％）抗－ＨＣＶ阳性,７例（１７．５％）ＨＣＶ－ＲＮＡ阳性、经统计学处理有显著性差异（Ｐ〈０．０－     

常用消毒方法对HBsAg灭活作用

常用消毒方法对ＨＢｓＡｇ灭活作用郑军（１）姚晟（１）尹园解（２）（１宁波１１３医院２宁波海曙区卫生防疫站３１５０００）～～～～～～～～～～～～～～～～～～～～～～～口腔科器械消毒常用压力蒸汽和消毒剂浸泡等方法。为了解常用几种消毒方法对ＨＢｓＡｇ灭活效...     

丙型肝炎病毒感染与扁平苔藓

扁平苔藓（ＬＰ）是以异常细胞免疫反应为主的疾病，病因不清。但越来越多的研究表明ＬＰ与丙型肝炎病毒（ＨＣＶ）感染有关。ＨＣＶ是单股正链ＲＮＡ病毒，目前可检测其特异性抗体和ＨＣＶ ＲＮＡ。ＬＰ患者中ＨＣＶ的高感染率提示应对ＬＰ患者进行ＨＣＶ检测。     

口腔粘膜扁平苔藓患者丙型肝炎病毒感染的初步研究

目的：了解ＯＬＰ患者ＨＣＶ感染情况,探讨ＨＣＶ感染与ＯＬＰ之间的关系。方法：用全自动生化检测仪,酶联免疫测定及ＰＣＲ法分别测定４１名ＯＬＰ患者和３８名对照者外周血ＳＧＰＴ、ＳＧＯＴ、抗－ＨＣＶ和ＨＣＶ－ＲＮＡ。结果：４１名ＯＬＰ患者中,１５人（３６．６％）有肝酶异常升高、１２人（２９．３％）抗－ＨＣＶ阳性,１０人（２４．４％）ＨＣＶ－ＲＮＡ阳性;而３８名对照组中,６人（１５．８％）有肝酶异常升高,３人（７．９％）抗－ＨＣＶ阳性,３人（７．９％）ＨＣＶ－ＲＮＡ阳性,ＯＬＰ组的上述三项指标均较对照组为高（Ｐ＜０．０５、Ｐ＜０．０１、Ｐ＜０．０５）,两组存在明显的差异。结论：国人ＯＬＰ患者存在较高的ＨＣＶ感染率,表明有相当部份的ＯＬＰ患者体内有ＨＣＶ存在与复制,ＯＬＰ的发病可能与此有一定的关系。     

金星消毒液对口腔科器械消毒效果的初步研究

金星消毒液对口腔科器械消毒效果的初步研究赵勤俞未一孙金竺徐道寅（南京医学院附属口腔医院内科流行病学教研室２１０００９）～～～～～～～～～～～～～～～～～～～～乙型肝炎病毒表面抗原（ＨＢｓＡｇ）阳性的传播，主要是通过血液与唾液。而口腔疾病，医生在诊治时...     

Hepatitis C virus infection and its dental implications

In the last two decades dentists and other dental workers have been called attention to the risk of infection with blood-borne pathogens by a few reports. Before Hepatitis B vaccine became available in 1982, dentists and oral surgeons were reported to have a higher prevalence of Hepatitis B Virus (HBV) than other health-care workers and the general population. The first cases of AIDS were recognised in 1981, and in 1988 dentists infected with Human Immunodeficiency Virus was already registered without any other potential risk factor except his occupation. Hepatitis C Virus (HCV), a positive stranded RNA virus was isolated for the first time from a chronically infected chimpanzee by a human VIII factor concentrate. Now HCV is regarded to be the cause of most cases of non-A-non-B hepatitis. Although the risk of HCV infection among health-care workers is lower than it was in the case of HBV infection, there is some evidence of occupational transmission of HCV. The lack of effective vaccine, the proportion of chronic infections, and the limited success of therapy emphasises the importance of the problem for the dentists in practice. In this report the authors surveyed the epidemiology, transmission, and nature of HCV infection, and suggested some possible connection between the virus and certain oral diseases. The authors expounded some general aspects of management of HCV-infected patients in the dental practice and underlined the importance of preventing occupational transmission.     

Hepatitis: still a concern?

Although some forms of viral hepatitis were identified more than 50 years ago, hepatitis continues to have an impact on the practice of dentistry. Possible transmission in the dental setting, management of the chronically ill, and legal issues related to treatment of infectious patients combine to emphasize that hepatitis is still an important issue for dental health care workers. Currently, 7 viral forms are recognized. Those with predominantly enteral modes of transmission-including HAV, HEV, and HFV-are of minor concern in the dental environment. HBV, the most infectious blood-borne pathogen, has been largely controlled in this country by vaccination and the use of universal precautions. HDV is an incomplete virus that has HBV infection as a prerequisite. HCV is of great concern today for several reasons. A high percentage of HCV infections results in chronic disease. Most cases remain asymptomatic for an extended period of time, and many have no identifiable risk factors. Currently, no vaccination is available for HCV. Patients infected with HCV present a management challenge, because they may ultimately develop serious liver dysfunction. In fact, HCV infection is presently the most common reason for liver transplantation. By understanding the various forms of viral hepatitis and following recommended infection control and vaccination protocols, the dental healthcare worker can treat infected patients in a manner that is safe for both patients and dental health care workers.     

Lack of evidence of hepatitis in patients with oral lichen planus in China: A case control study

Background

China has been one of the countries with high prevalence of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) liver disease. And lichen planus is an extrahepatic manifestation of patients with chronic HCV infection. This case-control study was conducted to investigate the relationship between oral lichen planus (OLP) and HBV/HCV infection in China.

Material and Methods

A total of 776 patients, including 150 patients with OLP (Group OLP), 429 inpatients from the Trauma Ward of Oral and Maxillofacial Surgery Department (Group A), 110 patients with other oral mucosal diseases, but without a reported association with HCV infection (Group B) and 87 patients with oral lichenoid lesion (Group OLL), were compared with their seroprevalence of anti-HCV antibody (HCVAb), hepatitis B surface antigen (HBsAg) and the parameters of liver functions. Moreover, the clinical characteristics of OLP were also observed, such as gender, age, chief complaint, course of the disease, clinical type, sites involved and so on.

Results

The positive rates of HCVAb and HBsAg in OLP patients were 0.7% and 4%, respectively. Neither HCVAb nor HBsAg was associated with OLP as demonstrated by both the univariate and the multivariate analyses. The clinical features and liver functions of OLP patients with negative or positive HBsAg were nearly the same.

Conclusions

Our findings verify that there is no association between OLP and hepatitis and there is no need to run a screening test for HCV or HBV in OLP patients in China. Key words:Oral lichen planus, hepatitis C virus, hepatitis B virus.     

Managing the care of patients infected with bloodborne diseases

BACKGROUND: The emergence of the bloodborne pathogens HIV, the cause of AIDS; hepatitis B virus, or HBV; and hepatitis C virus, or HCV, has been a milestone in the history of the dental profession. In the early 1980s, new cases of AIDS increased dramatically, and fear of acquiring this disease compelled clinicians to modify the delivery of medical and dental care to allay fears of transmission on the part of both patients and health care workers. Arguably, the AIDS pandemic has been the most significant factor in the evolution and delivery of modern medical and dental care in the last century. OVERVIEW: To help ally fears and remove barriers to caring for the HIV population, the Centers for Disease Control and Prevention, or CDC, introduced the concept of universal precautions in 1983. This was followed by the Occupational Safety and Health Administration's Bloodborne Pathogens Standard in 1991. Specific to the dental profession was the development of the principles of infection control in dentistry recommended by the CDC (1993); the American Dental Association (1995) and the Organization for Safety & Asepsis Procedures (1997). While initially difficult for some clinicians to acknowledge, these recommendations now are universally accepted throughout the profession, and provision of oral health care to patients infected with bloodborne disease is becoming commonplace. Compliance with recommended infection control practices remains an important component of dental practice. But it must be accompanied by an understanding of infectious and bloodborne diseases and the medical/dental management of the care of infected dental patients. CONCLUSIONS AND PRACTICE IMPLICATIONS: The emergence of the bloodborne pathogens and the increasing number of infected patients who seek oral health care compel clinicians to have a thorough knowledge about bloodborne diseases and the medical/dental management of the care of patients presenting with HIV, HBV or HCV infection.     

Transfusion transmitted virus (TTV) in dental patients

Transfusion transmitted virus (TTV) is a new DNA virus found in patients with post-transfusion hepatitis. The prevalence of this virus among dental patients has not been reported, therefore, the prevalence of TTV infection in consecutive dental inpatients was evaluated. TTV DNA was assayed by the polymerase chain reaction (PCR) in 441 dental inpatients with oral cancer (n=192) or oral cysts (n=249). The serum HBs antigen and HCV antibody as well as aspartate transaminase (AST), alanine transaminase (ALT), and gamma glutamyl transpeptidase (gamma-GTP) concentrations were also measured. Of 441 subjects, 137 were infected with TTV (31.1%). This prevalence of TTV was much higher than that of HBV or HCV (HBV 1.2%; HCV 6.0%) in these dental patients. There was no gender or age difference in the prevalence of TTV infection. Of the 192 patients with oral cancer, 57 subjects had TTV in their sera, while 80 of 249 with oral cystic disease had TTV. The prevalence of TTV was similar between the two different disease groups. Neither the serum ALT nor serum AST concentrations were different between the subjects positive and negative for TTV DNA. In hospitalized dental patients, 31.1% were infected with TTV. The prevalence of TTV was much higher than that of HBV or HCV. There was no difference in the prevalence of TTV between subjects with cancer and cysts. Dentists should maintain high standards of infection control when treating any dental patient.     

Prevalence of hepatitis viral infection in dental patients with impacted teeth or jaw deformities

OBJECTIVE: The prevalence of infection with hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis G virus (HGV), and transfusion-transmitted viruses (TTV) was evaluated in patients with impacted teeth or jaw deformities. STUDY DESIGN: Of 486 patients, 268 had serum samples available for retrospective TTV DNA and HGV RNA assays. In addition, the sera of 404 patients were assayed for HB surface antigen and the sera of 340 were assayed for HCV antibody. RESULTS: HGV RNA was detected in 3 of 268 patients (1.1%), and TTV DNA was detected in 60 of 268 (22.4%). Of 404 patients, 3 had HB surface antigens (0.7%). Furthermore, 13 of 340 were HCV-seropositive (3.8%). The rate of infection was similar between patients with impacted teeth and those with jaw deformities, respectively, as follows: 1.1% versus 0%, respectively, for HBV prevalence; 4.1% versus 3.2% for HCV prevalence; 1.8% versus 0% for HGV prevalence; and 22.9% versus 21.4% for TTV prevalence. CONCLUSIONS: Universal precautions to prevent hepatitis and TTV infection during oral surgical procedures are important.     

Risk and prevention of hepatitis C virus infection. Implications for dentistry.

BACKGROUND: The occupational risk of hepatitis C virus, or HCV, infection in dentistry is very low. Nonetheless, the lack of an effective vaccine, the high rates of chronic infection and the limited effectiveness of treatment may cause concern for dental workers who come into contact with blood in their daily practices. DESCRIPTION OF THE DISORDER: The authors discuss the natural history, diagnosis and treatment, and patterns of transmission of HCV infection, including the Centers for Disease Control and Prevention's recommendations for management and follow-up of health care workers after occupational exposure to HCV. CLINICAL IMPLICATIONS: In the absence of an effective vaccine or postexposure prophylaxis, prevention of occupational transmission of HCV in dental settings continues to rely on the use of universal precautions, including barrier precautions and the safe handling of sharp instruments.     

Hepatitis viruses A, B, C, D, E and G: implications for dental personnel

BACKGROUND: This article provides dental personnel with a brief overview of the different types of viral hepatitis, including their epidemiology, clinical features, prevention and treatment. It also explores the ramifications of these diseases for the practice of dentistry. DESCRIPTION OF THE CONDITION: Viral hepatitis is an inflammation of the liver caused by one of at least six distinct viruses. The hepatitis A and E viruses, or HAV and HEV, are enterically transmitted viruses that produce acute disease only. The hepatitis B, C and D viruses, or HBV, HCV and HDV, are most efficiently transmitted by infected blood, but also can be transmitted by exposure to other infectious bodily fluids. These three viruses can cause acute or chronic hepatitis. People with chronic viral hepatitis can develop chronic liver disease, cirrhosis and hepatocellular carcinoma. The hepatitis G virus was recently identified, and its ability to cause clinically significant acute or chronic hepatitis is unknown. CONCLUSIONS: Dental health care workers, or DHCWs, should be concerned primarily with HBV, HCV and HDV, as occupational exposure to these pathogens places them at risk of developing acute or chronic infections. Vaccines and immune globulins are available and effective in protecting against infections with HAV, HBV and HDV, but not HCV. CLINICAL IMPLICATIONS: DHCWs should become knowledgeable about viral hepatitis. They should be vaccinated against hepatitis B. Adherence to infection control measures will help prevent occupational transmission of all bloodborne pathogens, including hepatitis viruses.     

Review of hepatitis non-A, non-B: the potential hazards in dental care

Several of the common viral agents that can cause hepatitis have been detected in body fluids, including saliva and blood, which may both form important routes for transmission of disease. The viruses most commonly implicated include hepatitis A virus (HAV), hepatitis B virus (HBV), cytomegalovirus (CMV), and Epstein-Barr virus. Hepatitis delta virus (HDV) can be found in persons positive for hepatitis B surface antigen (HBsAg) and presumably follows the same routes of transmission as HBV. Herpes simplex and echo viruses can cause hepatitis on rare occasion. Other agents, not yet positively identified but collectively referred to as non-A, non-B are also believed to follow the same routes as HBV and/or HAV. The aim of this reviews is twofold. First, we will discuss hepatotropic viruses other than HBV that may be spread via saliva and blood and, therefore, should be considered along with HBV as a potential health hazard to dental personnel and also to dental patients. The second aim is to highlight the epidemiology and the risk of transmission of these viral infections. The potential hazards are discussed in relation to those associated with HBV and human immunodeficiency viruses (HIV), implicated in the acquired immunodeficiency syndrome (AIDS).     

No evidence of hepatitis C virus infection in Serbian patients with oral leukoplakia

BACKGROUND: A review of the literature reveals controversy regarding the relationship between hepatitis C virus (HCV) infection and oral leukoplakia (OL). The aim of this study was to determine the frequency of HCV antibodies in patients with OL and control subjects resident in Serbia. METHODS: In this cross-sectional study 73 consecutive patients with histologically proven OL and 90 control subjects, whose age and gender were matched, were examined for the presence of serological evidence of chronic hepatic disease, hepatitis B surface antigen (HBsAg) and anti-HCV seropositivity. RESULTS: None of the patients with OL or control subjects had antibodies to HCV or HBsAg. All patients with OL and control subjects had normal liver function. CONCLUSION: The present data indicate that patients with OL resident in Serbia do not have evidence of HCV or HBV infection.