Predominance of HCV type 2a in saliva from intravenous drug users

Abstract

Paired serum and saliva samples were collected simultaneously from 50 intravenous drug users with serologically proven hepatitis C virus infection. The oral health of the volunteers was also assessed. Hepatitis C virus RNA was detected by nested PCR, employing primers from the 5' noncoding region. Positive PCR products were sequenced using the Sequenase PCR Product Sequencing Kit (Amersham Life Sciences). HCV RNA was detected in 33 (66%) of the 50 serum samples. HCV RNA was detected in 19 (57.6%) of the corresponding 33 saliva samples. There was no correlation between oral health status or HIV seropositivity and the detection of HCV in saliva. However, subjects with HCV in their saliva were significantly more likely to complain of xerostomia (P < 0.05). Isolate genotypes were identified in paired serum and saliva of 15 intravenous drug users. HCV genotypes 1, 2, 3 and 6 were detected in both specimens. In seven cases, a differing HCV genotype was found in serum compared to the paired saliva specimen. The distributions of genotypes in serum and saliva were very different, with genotype 2a more common in saliva than serum (P < 0.005). These data suggest that in some cases the source of salivary HCV may not be serum transudation along the periodontal membrane or across damaged mucosa, and that an alternative local source, possibly the salivary glands themselves, should be considered.

Detection of hepatitis C virus RNA in saliva samples from patients with seric anti-HCV antibodies

“…Discrepancy between blood and saliva HCV genotypes was reported by Roy et al [7], in drug abusers; he found that genotype 2 was more prevalent in saliva samples from these patients.…”

“…Five out of 38 publications reported100% HCV-RNA detection in saliva samples from HCV-positive patients [16,17,25,29,38]; however, only a few cases or only patients with sialoadenitis were considered in these studies, which may represent a caveat. When reports with sample sizes larger than 30 HCV-positive patients were considered separately, the broad variability of frequencies was evident, ranging from 0 to 66% [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. This variation in HCV-RNA detection frequencies in saliva samples may be due to the saliva sampling method used.…”

Hepatitis C virus quantification in serum and saliva of HCV-infected patients

“…Although HCV can enter the saliva via the gingival sulcus (Maticic et al 2001), this cannot be the sole route because HCV RNA has been found in the saliva of edentate patients (Roy et al 1998). An alternative mechanism for viral entry into saliva is active HCV replication in the salivary glands (Arrieta et al 2001).…”

“…An alternative mechanism for viral entry into saliva is active HCV replication in the salivary glands (Arrieta et al 2001). This mechanism would explain the detection of different viral genotypes in the serum and saliva of individual patients (Roy et al 1998) and the existence of patients with HCV RNA-negative serum and HCV RNA-positive saliva (Harle et al 1993).…”

“…However, HCV RNA has been measured in the saliva of infected individuals independent of mucosal lesions and periodontal disease (Liou et al 1992, Fabris et al 1999, Hermida et al 2002, Lins et al 2005. Additionally, HCV could enter the saliva via peripheral blood mononuclear cells (PBMCs) (Roy et al 1998, Fabris et al 1999, Maticic et al 2001; however, the presence of HCV RNA in PBMCs and saliva have not been closely correlated (Young et al 1993). The detection of HCV RNA in saliva and the existence of a correlation between the viral load in saliva and other compartments have been demonstrated in previous studies (Mariette et al 1995, Hermida et al 2002, Eirea et al 2005 In this work, a quantitative PCR assay was used to determine HCV viral load levels in the saliva and serum of patients.…”