Farghaly A G, Mansour G A, Mahdy N H, Yousri A
Tropical Health Department, High Institute of Public Health, Alexandria University.
J Egypt Public Health Assoc. 1998;73(5-6):707-35.
The aim of the present case control study was to identify seroprevalence of hepatitis B and C virus (HBV and HCV) infections among one hundred cases with periodontal disease (71% gingivitis and 29% adult periodontitis) and one hundred controls with healthy gingiva matdhed for age and sex. Moreover, it aimed to detect hepatitis markers in saliva samples corresponding to the positive sera. Different risk factors associated with hepatitis infection and detectability rate of hepatitis markers were also studied.
enzyme linked immunosorbent assay (ELISA) technique was used to detect the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti HBc), e antigen (eAg) and antibody to hepatitis C virus (anti HCV) both in serum and saliva samples. HCV RNA was detected by polymerase chain reaction (PCR) technique. Oral examination was performed for assessment of simplified Oral Hygiene Index (OHI-S), Papillary Bleeding Index (PBI), probing pocket depth and loss of fibre attachment.
cases with periodontal disease showed higher percentages of hepatitis exposure (hepex; anti HCV and/or anti HBc) and significantly higher anti HCV seropositivity than the controls (26% and 13% versus 22% and 8%, respectively). No difference in HBsAg carrier rate nor in anti HBc seropositivity was elicited. Furthermore, cases with periodontal disease showed higher detectability rate of HBsAg, anti HBc, anti HCV or both anti HCV and/or anti HBc in whole unstimulated saliva than the controls (100% vs 66.7%, 50% vs 23.5%, 23.1% vs 0.0% and 42.3% vs 18.2%, respectively). Stepwise logistic regression delineated two significant factors associated with the risk of hepatitis exposure, the first predictor was the rural residence and the second one was the history of blood transfusion (OR=3.10, 2.94, respectively). Periodontal disease, severity of bleeding and bad oral hygiene were associated with the risk of hepatitis infection and with the detectability of hepatitis markers in the whole saliva.
本病例对照研究的目的是确定100例牙周病患者（71%为牙龈炎，29%为成人牙周炎）和100例年龄及性别匹配的牙龈健康对照者中乙型和丙型肝炎病毒（HBV和HCV）感染的血清阳性率。此外，其目的是检测与阳性血清对应的唾液样本中的肝炎标志物。还研究了与肝炎感染相关的不同危险因素以及肝炎标志物的可检测率。
采用酶联免疫吸附测定（ELISA）技术检测血清和唾液样本中乙型肝炎表面抗原（HBsAg）、乙型肝炎核心抗原抗体（抗HBc）、e抗原（eAg）和丙型肝炎病毒抗体（抗HCV）的存在情况。通过聚合酶链反应（PCR）技术检测HCV RNA。进行口腔检查以评估简化口腔卫生指数（OHI-S）、龈乳头出血指数（PBI）、探诊袋深度和纤维附着丧失情况。
牙周病患者的肝炎暴露（hepex；抗HCV和/或抗HBc）百分比更高，抗HCV血清阳性率显著高于对照组（分别为26%和13%，而对照组为22%和8%）。HBsAg携带率和抗HBc血清阳性率无差异。此外，牙周病患者在全唾液中HBsAg、抗HBc、抗HCV或抗HCV和/或抗HBc两者的可检测率高于对照组（分别为100%对66.7%、50%对23.5%、23.1%对0.0%和42.3%对18.2%）。逐步逻辑回归确定了与肝炎暴露风险相关的两个重要因素，第一个预测因素是农村居住情况，第二个是输血史（OR分别为3.10和2.94）。牙周病、出血严重程度和口腔卫生不良与肝炎感染风险以及全唾液中肝炎标志物的可检测性相关。
