Detection of hepatitis C virus RNA in saliva of patients with active infection not associated with periodontal or liver disease severity

Abstract

BackgroundHepatitis 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.MethodsPatients 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.ResultsA 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.ConclusionHCV-RNA in saliva was associated with the level of serum viral load but not with periodontal or liver disease severity.

Hepatitis C Infection and Periodontal Disease: Is there a Common Immunological Link?

“…Therefore, periodontal status might be considered a contributing factor for the presence of HCV in saliva [ 61 ]. While the aspartate transaminase (AST) salivary levels have recorded significantly higher levels in samples from patients with chronic periodontal disease and the values of AST correlate to the degree of periodontal tissue injury [ 62 ], viral RNA molecules have been found in saliva samples of HCV patients regardless of their periodontal status [ 63 ].…”

Oral Health: The Need for Both Conventional Microbial and Molecular Characterization

“…There are numerous diseases whose impact has been illustrated: 19 genes are differentially expressed in the saliva of Sjogren’s syndrome patients [ 22 ], and autoantigens in the saliva differ according to the subtype of systemic lupus erythematous [ 23 ]. The blood-borne pathogens, human immunodeficiency virus [ 24 ] and hepatitis C virus antibodies can be found in salivary concentrations that correlate to the systemic viral load [ 25 ]. With respect to metabolic diseases, 65 proteins are differentially expressed in the saliva of patients with type II diabetes mellitus [ 26 ].…”

Oral Health: The Need for Both Conventional Microbial and Molecular Characterization

“…There are numerous diseases whose impact has been illustrated: 19 genes are differentially expressed in the saliva of Sjogren's syndrome patients [22], and autoantigens in the saliva differ according to the subtype of systemic lupus erythematous [23]. The blood-borne pathogens, human immunodeficiency virus [24] and hepatitis C virus antibodies can be found in salivary concentrations that correlate to the systemic viral load [25]. With respect to metabolic diseases, 65 proteins are differentially expressed in the saliva of patients with type II diabetes mellitus [26].…”