Oral Health Topics
Hepatitis C Virus HCV
Approximately 3.2 million Americans are infected with hepatitis C virus (HCV). Chronic HCV increases the risk of developing serious liver disease such as cirrhosis and cancer. Most studies suggest that dental professionals are no more likely to be infected than the general population. Therefore, their risk of occupationally acquiring HCV, when appropriate infection control procedures are followed, appears to be very low. Nevertheless, HCV is still a concern for anyone who may be accidentally exposed to blood in the course of their work.
The hepatitis C virus was discovered in the late 1980s. Chronic hepatitis may not be detected for several decades, until the patient experiences symptoms of advanced liver disease, such as cirrhosis or liver cancer. Chronic liver disease associated with HCV infection leads to an estimated 8,000 to 10,000 deaths each year, and HCV is the number one reason for liver transplantation in the United States.
HCV is most prevalent among people with large or frequent exposure to blood, including people with hemophilia and injecting drug users. People who received blood transfusions before 1990 and patients undergoing dialysis treatment also show a higher-than-average prevalence of HCV infection.
Dentists and dental professionals are no more likely to be infected than the general population, and their risk of becoming infected at work appears to be very low. Still, because no effective vaccine or post-exposure prophylaxis is available for HCV; the rate of chronic infection is high; and treatment for HCV infection is of limited efficacy. HCV is a concern for health care workers—including dental workers—who may come into contact with blood.
Data are insufficient to estimate the occupational risk of HCV infection among all health care professionals (HCP), but the majority of studies indicate the prevalence of HCV infection among dentists, surgeons, and hospital-based HCP is similar to that among the general population, approximately one to two percent.
According to the CDC, HCV appears not to be transmitted efficiently through occupational exposures to blood. Follow-up studies of HCP exposed to HCV-infected blood through percutaneous or other sharps injuries have determined a low incidence of seroconversion (mean: 1.8 percent; range, 0 to 7 percent). One study determined transmission occurred from hollow-bore needles but not other sharps. Although these studies have not documented seroconversion associated with mucous membrane or non-intact skin exposure, at least two cases of HCV transmission from a blood splash to the conjunctiva and one case of simultaneous transmission of HCV and HIV after non-intact skin exposure have been reported.
It is especially important to prevent the transmission of HCV. In health care settings, prevention relies on the use of standard precautions, including barrier precautions (e.g., gloves, masks, and protective eyewear) and the safe handling of sharp instruments.