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Hepatitis B, Hepatitis C and Liver Disease: A Review for the Dental Practitioner Iain Macpherson Paul N Brennan John F Dillon Dental Update 2024 49:1, 707-709.
Authors
IainMacpherson
MBChB, MRCP(UK)
Clinical Research Fellow, Division of Clinical and Molecular Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee
Professor of Gastroenterology and Hepatology, Division of Clinical and Molecular Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee
The prevalence of chronic liver disease continues to rise, and important causes include viral infections, such as hepatitis B and hepatitis C. Both of these viruses can be contracted by healthcare workers through an inoculation injury and can lead to liver cirrhosis and cancer. In addition, chronic liver disease can result in disorders of liver function, including coagulopathy and abnormal metabolism of drugs widely used in dentistry. This article reviews current prevalence, transmission rates and treatment of hepatitis B and hepatitis C, as well as particular considerations for dental patients with liver disease.
CPD/Clinical Relevance: Viral hepatitis remains a risk to all healthcare workers, and patients with liver disease provide various challenges when providing dental treatment.
Article
Blood borne viruses (BBVs) are transmitted through the transfer of blood or other virus-containing bodily fluids between individuals. Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) account for the majority of such infections, while there is evidence that hepatitis E virus (HEV), usually transmitted through the faecal–oral route, can also be transmitted through blood to blood transfer.1,2
Globally, healthcare workers (HCWs), including dentists, are at risk of contracting such infections. Routes of transmission include inoculation injury, and blood or saliva entry through a wound. In 2000, it was estimated that HCWs contracted 66,000 HBV and 16,000 HCV infections through percutaneous injuries (PIs).3
HBV, HCV and HEV often result in acute, self-limiting illnesses, but can lead to chronic infection, resulting in chronic inflammation of the liver (hepatitis). Chronic viral hepatitis can cause liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC), and in some countries is the leading cause of liver transplantation.4
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