Lodi, Giovanni; (1998) Oral and dental aspects of hepatitis C virus infection. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Oral and dental aspects of the hepatitis C virus (HCV) infection were investigated, with particular attention to the possible associated oral conditions, such as oral lichen planus (LP) and Sjogren's syndrome (SS), and the risk of nosocomial transmission within dental health care. The prevalence of oral LP in a group of Italian patients with HCV-associated liver disease was investigated as well as the seroprevalence of anti-HCV among Italian patients with oral LP; both the studies confirmed the association between oral LP and HCV infection, at least in countries at high prevalence. HCV 1b was the most common genotype found in a group of patients with oral LP and HCV infection, although no significant link between a particular genotype and HCV-associated oral LP could be demonstrated. A small proportion of the same group was also found to be co-infected by hepatitis G virus (HGV), a novel virus whose pathological potential is still to be elucidated. Anti-epithelial antibodies were found in a significant proportion of another group of patients with HCV-associated oral LP, although confirming the high frequency of autoantibodies in HCV-positive subjects, the exact role of these antibodies remains unclear. The presence of HCV genome in oral LP tissues has been demonstrated for the first time and the expression of HCV antigens investigated by immunohistochemistry. In addition the histological and serological features of some of HCV-associated LP were compared with those of the idiopathic form, showing some differences in the tissue expression and serological levels of some adhesion molecules and immunoglobulins. The first case of malignant change in patient with HCV-associated LP was also presented. A study of a group of English patients with SS showed no association with HCV infection, possibly due to the very low prevalence of HCV in the UK. A low prevalence of HCV infection was found among a group of dental health care workers, thus indicating that an occupational acquisition of HCV is unlikely in UK dental health care. Finally the knowledge of HCV infection among European dental students was surveyed and revealed the need for improved education about aspects of HCV infection relevant to dentists.

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