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Open Access Research article

Detection of hepatitis C virus RNA in saliva of patients with active infection not associated with periodontal or liver disease severity

Francisca Sosa-Jurado1*, Verónica L Hernández-Galindo2, Daniel Meléndez-Mena3, Miguel A Mendoza-Torres3, Fernando J Martínez-Arroniz4, Verónica Vallejo-Ruiz1, Julio Reyes-Leyva1 and Gerardo Santos-López1*

Author Affiliations

1 Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Km 4.5 Carretera Federal Atlixco-Metepec, Metepec, Puebla CP 74360, México

2 Maestría en Ciencias en Investigación Clínica, Escuela Superior de Medicina y Homeopatía, Instituto Politécnico Nacional, Distrito Federal, México

3 Servicio de Gastroenterología, Hospital de Especialidades, Unidad Médica de Alta Especialidad, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, Puebla, México

4 Facultad de Estomatología, Benemérita Universidad Autónoma de Puebla, Puebla, Puebla, México

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BMC Infectious Diseases 2014, 14:72  doi:10.1186/1471-2334-14-72

Published: 10 February 2014

Abstract

Background

Hepatitis C virus (HCV) is mainly transmitted by parenteral route, being blood transfusion and intravenous drug use the most frequent risk factors. However, it has been suggested that there are other routes of transmission. There are several studies where HCV RNA has been detected in saliva of patients infected with HCV, and epidemiological studies have proposed the dental treatments as possible risk factors for HCV transmission. The purpose of this study was to detect the presence of HCV RNA in saliva of patients with active infection and associating with periodontal or liver disease.

Methods

Patients with quantifiable HCV-RNA in serum were enrolled in the study. Periodontal disease was assessed using the modified gingival index (MGI). Presence of dental plaque was assessed with the use of disclosing tablets. Patients were clinically and laboratory evaluated to identify the stage of liver disease, the HCV RNA was determinate in saliva by nested RT-PCR. To determine associations between different parameters univariate and multivariate analysis were used.

Results

A total of 45 patients were included. Of these patients, 21 (46.6%) had hepatitis, 23 (51.1%) had cirrhosis and one patient (2.4%) presented hepatocellular carcinoma (HCC). Viral loads in serum ranged from 2.31–6.68 log IU/ml with a mean of 5.46 log IU/ml (95% CI 5.23–5.70). HCV RNA was positive in saliva of 29 patients (64.4%) and was not detected in 16 (35.6%). For univariate analysis three independent variables were associated with the detection of HCV-RNA in saliva: gender, viral load and dental plaque and multivariate analysis only one independent variable viral load >5.17 log IU/mL remained significantly associated with the detection of HCV in saliva (p = 0.0002). A statistical difference was observed when viral load was analyzed, log 5.85 IU/mL (95% CI 5.67–6.02) for patients with HCV in saliva vs. log 4.77 IU/mL (95% CI 4.35–5.19) for patients without HCV in saliva (p = 0.0001). The detection of HCV-RNA in saliva was more frequent in patients with relatively high serum viral loads.

Conclusion

HCV-RNA in saliva was associated with the level of serum viral load but not with periodontal or liver disease severity.

Keywords:
Periodontal disease; Viral load; Gingivitis prevalence; Risk factors; Liver disease severity