Averbukh Leon D, Wu George Y
Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Health Center, CT, USA.
J Clin Transl Hepatol. 2019 Dec 28;7(4):346-351. doi: 10.14218/JCTH.2019.00023. Epub 2019 Oct 28.
Hepatitis C (HCV) is a viral infection that affects an estimated 71 million people worldwide, with over 1 million new infections yearly. While medical treatments exist, HCV continues to be a significant public health concern. Primary prevention and transmission risk factor identification remain key in helping decrease disease prevalence. While intravenous drug use, healthcare exposure (i.e. blood transfusions and surgical care), and body modification (i.e. tattooing and piercings) are well accepted risk factors for HCV transmission, others remain controversial. Because dental practice is often associated with procedures and bleeding, the possibility of HCV transmission seemed reasonable to investigate. Here, we review the evidence for dental care as a potential risk factor for HCV transmission. We identified a total of 1,180 manuscripts related to HCV and dental care, of which 26 manuscripts were included in the study after exclusionary criteria were applied. As per our review of the available literature, in the developing world, the improper use of sterile technique and lack of provider education likely increases the risk of HCV transmission during dental care. In developed nations, on the other hand, general dental care does not appear to be a significant risk factor for HCV transmission in non-intravenous drug user patients; although, the improper use and reuse of anesthetics during procedures poses a rare potential risk for viral transmission.
丙型肝炎(HCV)是一种病毒感染,全球估计有7100万人受其影响,每年有超过100万新感染病例。虽然存在医学治疗方法,但HCV仍然是一个重大的公共卫生问题。初级预防和传播风险因素识别仍然是帮助降低疾病患病率的关键。虽然静脉注射吸毒、医疗暴露(即输血和外科护理)以及身体改造(即纹身和穿孔)是公认的HCV传播风险因素,但其他因素仍存在争议。由于牙科诊疗通常与手术和出血有关,因此研究HCV传播的可能性似乎是合理的。在此,我们回顾了牙科护理作为HCV传播潜在风险因素的证据。我们共识别出1180篇与HCV和牙科护理相关的手稿,应用排除标准后,其中26篇手稿被纳入研究。根据我们对现有文献的回顾,在发展中国家,无菌技术使用不当和医护人员缺乏教育可能会增加牙科护理期间HCV传播的风险。另一方面,在发达国家,一般牙科护理对于非静脉注射吸毒患者似乎不是HCV传播的重要风险因素;不过,手术过程中麻醉剂的不当使用和重复使用对病毒传播构成了罕见的潜在风险。