Aa
self-reinfection while on TX
It is suggested that during initial phase of tx one should keep changing the tooth brush more frequently. what are other things to watch for to avoide self- reinfection. Any ideas/suggestions?
Elaine,
it's always so sad to hear what you endured, but inspiring how brave you are.
However, the one thing that saves most health workers from getting this is not the gloving up, the gloving only helps IF that person has cuts, sores or torn nails on their fingers. We know HCV is not transmitting through uncut skin, or through saliva alone.
The points of entry are cuts, sores, bleeding gums, nasal mucosa and the eye membrane. Those are the only places the viron, small as it is can slip through and gain entry to our bloodstreams. So your sons care didn't expose you.
I did hospice care for a couple years and also know what all that cleaning up is like, but I don't believe thats how i got it. I'm basing when I got it on when I had fever, exaustion and inability to sleep and other symptoms which was soon on the heals of my quart of plasma and never before that.
I also don't think a minute amount of blood in the mouth will always infect, unless that person has cuts or bleeding gums as well, and if the blood makes it past the mouth there are so many lypocytes lining the throat, plus hydrocloric acid in the stomach, so they don't survive and gain entrance through that route, which explains why your daughter never got infected, and why married couples can remain negative while one is infected. The mouth is not the common route of transmission.
The only exception being, introducing virus into an open or bleeding gum, and since many people who brush regually do blled a little...they don't even know this but they do release some blood with each brushing in most cases, so that becomes the one exception. So until someone proves that a pin ***** and a couple dozen virons can not infect, I'm going to assume it can and does because that's what the current science is showing. Science has been wrong plenty and had to later correct itself, but until we know more, I'd rather defer to what has been shown and provem both in the petre dish AND in real life daily health care facilities world wide. Which is, that it does not take much to infect.
So while your family stories in general don't surprise me,
I am surprised the needle accident you had didn't expose you as thats how many health care workers got this. Someone is definitely looking out for you! Yet that doesn't mean that needle accidents don't account for a large number of cases in helth workers, because they do.
mb
it's always so sad to hear what you endured, but inspiring how brave you are.
However, the one thing that saves most health workers from getting this is not the gloving up, the gloving only helps IF that person has cuts, sores or torn nails on their fingers. We know HCV is not transmitting through uncut skin, or through saliva alone.
The points of entry are cuts, sores, bleeding gums, nasal mucosa and the eye membrane. Those are the only places the viron, small as it is can slip through and gain entry to our bloodstreams. So your sons care didn't expose you.
I did hospice care for a couple years and also know what all that cleaning up is like, but I don't believe thats how i got it. I'm basing when I got it on when I had fever, exaustion and inability to sleep and other symptoms which was soon on the heals of my quart of plasma and never before that.
I also don't think a minute amount of blood in the mouth will always infect, unless that person has cuts or bleeding gums as well, and if the blood makes it past the mouth there are so many lypocytes lining the throat, plus hydrocloric acid in the stomach, so they don't survive and gain entrance through that route, which explains why your daughter never got infected, and why married couples can remain negative while one is infected. The mouth is not the common route of transmission.
The only exception being, introducing virus into an open or bleeding gum, and since many people who brush regually do blled a little...they don't even know this but they do release some blood with each brushing in most cases, so that becomes the one exception. So until someone proves that a pin ***** and a couple dozen virons can not infect, I'm going to assume it can and does because that's what the current science is showing. Science has been wrong plenty and had to later correct itself, but until we know more, I'd rather defer to what has been shown and provem both in the petre dish AND in real life daily health care facilities world wide. Which is, that it does not take much to infect.
So while your family stories in general don't surprise me,
I am surprised the needle accident you had didn't expose you as thats how many health care workers got this. Someone is definitely looking out for you! Yet that doesn't mean that needle accidents don't account for a large number of cases in helth workers, because they do.
mb
I think the point is not when SVR is reached but when UND is achieved.
UNdetedtible can mean you srill have some few virons on board, or it could mean you have none. We don't know how many are truly free of virus during this time because most tesring goes down only to ..5 or .10....which translates to many thousands of virons still in ones body possibly. The only test which tells the tale accurately is seldom used due to expense and accessibilty to it, and insurance opposition.
Ergo, one could become truly virus free early in treatment. No one knows whether they are moping up the few virons left, or whether they are clear and just following protocol.
The only thing we do know for vertain is that the longer one treats while UND the better the odds of SV become, even for late responders they reached similar success stats when treating out.
Ergo one could reasonably assume that the mop up phase goes on for some time, perhaps throughout the treatment or extended treatment.
That said, your point is taken. Yet this doesn't rule out what some system may do differently. For instance early responders....and I'm sure you know of the new predictive tests and findings concerning them. They go UND in very few weeks, do they also carry virus the entire year? No one really knows this. So it is reasonable to assume that some do, and some do not. Their stellar responses having quickly wiped out any detectible virus, they may accually be virus free and just not know it yet.
That's my point.
No one knows at what point those last hangers on are gone, and so why reintroduce ANY back into the system.
Like I said, and this doesn't seem circular to me,,,,I would not knowingly put someone elses toothbrush to work in my mouth that I knew may have 100 HCV or HIV virons on it, and many toothbrushes have far more than that.
If I would not let someone else's virons into my system, then why would I reintroduce my own bacteria???? Either way it presents some risk.
mb
UNdetedtible can mean you srill have some few virons on board, or it could mean you have none. We don't know how many are truly free of virus during this time because most tesring goes down only to ..5 or .10....which translates to many thousands of virons still in ones body possibly. The only test which tells the tale accurately is seldom used due to expense and accessibilty to it, and insurance opposition.
Ergo, one could become truly virus free early in treatment. No one knows whether they are moping up the few virons left, or whether they are clear and just following protocol.
The only thing we do know for vertain is that the longer one treats while UND the better the odds of SV become, even for late responders they reached similar success stats when treating out.
Ergo one could reasonably assume that the mop up phase goes on for some time, perhaps throughout the treatment or extended treatment.
That said, your point is taken. Yet this doesn't rule out what some system may do differently. For instance early responders....and I'm sure you know of the new predictive tests and findings concerning them. They go UND in very few weeks, do they also carry virus the entire year? No one really knows this. So it is reasonable to assume that some do, and some do not. Their stellar responses having quickly wiped out any detectible virus, they may accually be virus free and just not know it yet.
That's my point.
No one knows at what point those last hangers on are gone, and so why reintroduce ANY back into the system.
Like I said, and this doesn't seem circular to me,,,,I would not knowingly put someone elses toothbrush to work in my mouth that I knew may have 100 HCV or HIV virons on it, and many toothbrushes have far more than that.
If I would not let someone else's virons into my system, then why would I reintroduce my own bacteria???? Either way it presents some risk.
mb
HCV is a blood born virus. It can live in dried blood for hours, or some believe maybe days.
To be infected, the virus must enter our blood stream, and replicate in our liver.
To 're-infected' you would have to CLEAR the virus (be SVR), then introduce into your bloodstream new virus.
So if you clear the virus where do these live healthy virions come from?
Don't tell me you cleared the virus and are SVR(can you be Reinfected if your not SVR?) but 4 days before SVR or und, you had a 'big enough viral load' that some virions got on your toothbrush, and now 4 days latter you are und or svr, and those little buggers on your toothbrush are still alive, and ready to infect you. Wow those toothbrush virions have impeccable timing, huh? Oh ya, also your gums were bleeding enough to get the virus on the toothbrush 4 days earlier, and bleeding bad enough now, 4 days latter to let virions enter your blood stream... ?
Remember HCV virus cannot replicate till it hits the liver, no replication on the toothbrush, or your mouth, or your bloodstream.
So those toothbrush virions have to make it past your first line mucous membrane immune system defense(iirr, macrophage), to your blood stream, which is flooded with antivirals and INf, then on to your liver in order to replicate...
hmmm....maybe the plastic in the toothbrush gives these toothbrush virions ''supervironic powers'...lmao
So lets say this far fetched scenario did happen, this very very small group of virions would have to survive the IFN blast that already eradicated them once before when HCV had a firm foothold on your system. Your original HCV infection had thousands or millions of live replicating virirons, and you cleared them with inf. Why would you think these same brand of virions, under the same INF gun,would now be able to take hold?
Very very unlikely, if possible at all.
To think about re-infection this way, is circle thinking imho
apache
To be infected, the virus must enter our blood stream, and replicate in our liver.
To 're-infected' you would have to CLEAR the virus (be SVR), then introduce into your bloodstream new virus.
So if you clear the virus where do these live healthy virions come from?
Don't tell me you cleared the virus and are SVR(can you be Reinfected if your not SVR?) but 4 days before SVR or und, you had a 'big enough viral load' that some virions got on your toothbrush, and now 4 days latter you are und or svr, and those little buggers on your toothbrush are still alive, and ready to infect you. Wow those toothbrush virions have impeccable timing, huh? Oh ya, also your gums were bleeding enough to get the virus on the toothbrush 4 days earlier, and bleeding bad enough now, 4 days latter to let virions enter your blood stream... ?
Remember HCV virus cannot replicate till it hits the liver, no replication on the toothbrush, or your mouth, or your bloodstream.
So those toothbrush virions have to make it past your first line mucous membrane immune system defense(iirr, macrophage), to your blood stream, which is flooded with antivirals and INf, then on to your liver in order to replicate...
hmmm....maybe the plastic in the toothbrush gives these toothbrush virions ''supervironic powers'...lmao
So lets say this far fetched scenario did happen, this very very small group of virions would have to survive the IFN blast that already eradicated them once before when HCV had a firm foothold on your system. Your original HCV infection had thousands or millions of live replicating virirons, and you cleared them with inf. Why would you think these same brand of virions, under the same INF gun,would now be able to take hold?
Very very unlikely, if possible at all.
To think about re-infection this way, is circle thinking imho
apache
Looking forward to the study that will tell us if more angels or virons can fit on the head of a pin. And, as for the ittby bitty size of a viron I'd expect that any viron that escapes one human must be suspended in something much larger - like a blood droplet.
I try not to over think things too much and even if I did, the medical community is what it is so theorizing or speculating on this issue is a waste of time for me. I'm sorry, my mind doesn't go to the "places" yours does. I'm not a researcher, I'm not an MD nor do I have any published studies. I've never felt the need to strip everything down to finite particles.
However, we both were slow responders and are extending treatment. If you changed your toothbrush as you indicated every week which you feel is giving SVR your best shot and have been UND sometime after 12 wks and remained so how come I'm UND sometime after 12 wks, still UND after 60 wks with a very sensitive PCR and used one of those electronic gizmos that I only changed the head on every 6 months? How do you justify that?
However, we both were slow responders and are extending treatment. If you changed your toothbrush as you indicated every week which you feel is giving SVR your best shot and have been UND sometime after 12 wks and remained so how come I'm UND sometime after 12 wks, still UND after 60 wks with a very sensitive PCR and used one of those electronic gizmos that I only changed the head on every 6 months? How do you justify that?
ouch you got me...
but seriously though, when my dentist admitted the possible dental exposures, which very few will EVER admit, and he added that blood becomes airborne with sonic cleaning and is inhaled by those around...
when a dentist tells you this you start to get scared.
Especially when he looks as sober as a hanging judge while he's telling you.
After all...we know colds and flu are spread through the air...right?
Doesn't take many inhale molecules to get sick either.
but have we ever considered that HCV and HIV are also made airborne in these offices?
How many virion must one inhale to become infected? One study said 20-40 virons only but currently, in vitro, the
Answer is still unknown, but that doesn't mean it's a good idea to make a teaspoon an hour go airborne now does it?
Certainly didn't make sense to my dentist or hygenist...
I'm just assuming it's because they don't want our disease and have discovered something the NIH is not too keen on telling us...like that more of us got it from medical and dental procedures than from shagging or snorting something.
mb
but seriously though, when my dentist admitted the possible dental exposures, which very few will EVER admit, and he added that blood becomes airborne with sonic cleaning and is inhaled by those around...
when a dentist tells you this you start to get scared.
Especially when he looks as sober as a hanging judge while he's telling you.
After all...we know colds and flu are spread through the air...right?
Doesn't take many inhale molecules to get sick either.
but have we ever considered that HCV and HIV are also made airborne in these offices?
How many virion must one inhale to become infected? One study said 20-40 virons only but currently, in vitro, the
Answer is still unknown, but that doesn't mean it's a good idea to make a teaspoon an hour go airborne now does it?
Certainly didn't make sense to my dentist or hygenist...
I'm just assuming it's because they don't want our disease and have discovered something the NIH is not too keen on telling us...like that more of us got it from medical and dental procedures than from shagging or snorting something.
mb
The post above just gave a viron size estimate based on current science.
Let’s go from there:
An HCV viron is estimated to have the length of between 30 and 40 nanometers.
Just an estimate there as these are too small for any device to really measure.
Some may be slightly bigger or smaller than others.
Current filtering devices can screen out most virions by using a 35 nm screening process so I’ll round up and say they maybe as big as 40 nm, the high end of the estimates.
Source is http://en.wikipedia.org/wiki/Nanometre........
With me so far?
OK>>>> .. <<<<<<
ok, you see the 2 periods above right? That distance between the is approximately 1 millimeter. That millimeter contains a million nanometers. 1,000,000 nanometers.
Ergo one viron at say 40nm divided into 1,000,000 equals 25,000 virons in the space of one linear millimeter.
Look at the dots again. You can fit at LEAST 25,000 or more virons between those 2 dots.
Remember the thread called “what do you think of this scary study?” in Medhelp just days ago?
That study said viral infection could occur with as few as 20-40 virons.
20 to 40 virons, and you can fit 25,000 between those two dots above!
How small then is the amount of blood then needed to grind back into your gums to reinfect you?
Can you see it? Can you detect or comprehend it’s tiny size?
I mean, if an amount so small we cannot see, nor even begin to imagine if honest, is all it takes to give the virus a chance to live in a new host….or the same old host…us….then why would we want to take that chance?
WHY?
Once I went UND I went to Dollar Store, where they had 6 packs of very decent toothbrushes for a buck, and I changed them weekly. If I changed them DAILY the cost would have been 50 bucks for the year.
Compare that to the suffering, the sides, the relationships strained or ruined…how can we even go there?
There is no comparison!
Maybe one needs to think about the alternative as possibly more suffering??
Just a thought.
Hand brushing works if done right, and it would cost 20 cents not 30 bucks to replace each brush.
For this I’d give up any electronic gismos.
For that matter, even 30 bucks seems like small change if you think about the possibility of getting reinfected or needing a transplant. How pennywise and pound foolish that will seem to a relapser heeding no cautionary tales…
I don’t know. I don’t want to look in that mirror and think, maybe if I’d done this differently or that.
I’d rather do my best now in every aspect so that regardless of outcome I can say I gave SVR my best shot!
If this seems anal well then shoot me, but an amount of blood so small we can’t imagine is all it takes to infect so what harm can precaution possibly do here.
Ask yourself this question….knowing NOW, that it only takes a 20-40 viron exposure to see healthy cells become infected…
Would you let someone else brush your teeth with something that “might” have even a hundred virons on it??
Would you let them rub that into your gums knowing those tissue cells open up and bleed easier than anywhere else on your body?
Would one do that?
Then by all means keep using that old brush….
to save yourself a few lousy “bucks”
and call those who take precaution names.
Rolleyes.
Yet I will take my brand of squirrelly precautions over the nonchalant attitude any day.
We are not scientists, and we do not understand all the methods of transmissions, so until we do, SHOULD we NOT be on guard?
I remember the day they put me under, and gave me plasma against my wishes…
And when I woke up I was furious and they ASSURED my, there was no way I could get Aids or anything from plasma. That was 20 years ago. It seems only yesterday they were that dumb…and it wasn’t long ago!
I’m wondering what 20 more years will do to our knowledge base.
So go with your instincts, and I’ll go with the current science, which only hints at, but doesn’t say for certain…
it’s not much,
but it’s better than hunches.
mb
Let’s go from there:
An HCV viron is estimated to have the length of between 30 and 40 nanometers.
Just an estimate there as these are too small for any device to really measure.
Some may be slightly bigger or smaller than others.
Current filtering devices can screen out most virions by using a 35 nm screening process so I’ll round up and say they maybe as big as 40 nm, the high end of the estimates.
Source is http://en.wikipedia.org/wiki/Nanometre........
With me so far?
OK>>>> .. <<<<<<
ok, you see the 2 periods above right? That distance between the is approximately 1 millimeter. That millimeter contains a million nanometers. 1,000,000 nanometers.
Ergo one viron at say 40nm divided into 1,000,000 equals 25,000 virons in the space of one linear millimeter.
Look at the dots again. You can fit at LEAST 25,000 or more virons between those 2 dots.
Remember the thread called “what do you think of this scary study?” in Medhelp just days ago?
That study said viral infection could occur with as few as 20-40 virons.
20 to 40 virons, and you can fit 25,000 between those two dots above!
How small then is the amount of blood then needed to grind back into your gums to reinfect you?
Can you see it? Can you detect or comprehend it’s tiny size?
I mean, if an amount so small we cannot see, nor even begin to imagine if honest, is all it takes to give the virus a chance to live in a new host….or the same old host…us….then why would we want to take that chance?
WHY?
Once I went UND I went to Dollar Store, where they had 6 packs of very decent toothbrushes for a buck, and I changed them weekly. If I changed them DAILY the cost would have been 50 bucks for the year.
Compare that to the suffering, the sides, the relationships strained or ruined…how can we even go there?
There is no comparison!
Maybe one needs to think about the alternative as possibly more suffering??
Just a thought.
Hand brushing works if done right, and it would cost 20 cents not 30 bucks to replace each brush.
For this I’d give up any electronic gismos.
For that matter, even 30 bucks seems like small change if you think about the possibility of getting reinfected or needing a transplant. How pennywise and pound foolish that will seem to a relapser heeding no cautionary tales…
I don’t know. I don’t want to look in that mirror and think, maybe if I’d done this differently or that.
I’d rather do my best now in every aspect so that regardless of outcome I can say I gave SVR my best shot!
If this seems anal well then shoot me, but an amount of blood so small we can’t imagine is all it takes to infect so what harm can precaution possibly do here.
Ask yourself this question….knowing NOW, that it only takes a 20-40 viron exposure to see healthy cells become infected…
Would you let someone else brush your teeth with something that “might” have even a hundred virons on it??
Would you let them rub that into your gums knowing those tissue cells open up and bleed easier than anywhere else on your body?
Would one do that?
Then by all means keep using that old brush….
to save yourself a few lousy “bucks”
and call those who take precaution names.
Rolleyes.
Yet I will take my brand of squirrelly precautions over the nonchalant attitude any day.
We are not scientists, and we do not understand all the methods of transmissions, so until we do, SHOULD we NOT be on guard?
I remember the day they put me under, and gave me plasma against my wishes…
And when I woke up I was furious and they ASSURED my, there was no way I could get Aids or anything from plasma. That was 20 years ago. It seems only yesterday they were that dumb…and it wasn’t long ago!
I’m wondering what 20 more years will do to our knowledge base.
So go with your instincts, and I’ll go with the current science, which only hints at, but doesn’t say for certain…
it’s not much,
but it’s better than hunches.
mb
The Particle Size Of Hepatitis C Virus Estimated By Filtration Through Microporous Regenerated Cellulose Fibre
Tazuko Yuasa1, Gen Ishikawa2, Sei-ichi Manabe2, Sadayoshi Sekiguchi3, Kenji Takeuchi1 and Tatsuo Miyamura1
1 Laboratory of Hepatitis Viruses II, Department of Enteroviruses, National Institute of Health, 2-10-35 Kamiosaki, Shinagawa-ku, Tokyo 141
2 Asahi Chemical Industries Co. Ltd., 1-1-1 Uchisaiwaicho, Chiyoda-ku, Tokyo 100
and3 Hokkaido Red Cross Blood Center, Yamanote 2-2, Nishi-ku, Sapporo 063, Japan
To estimate the particle size of hepatitis C virus (HCV), a major causative agent of post-transfusion non-A, non-B hepatitis, we filtered plasma or serum samples through microporous cellulose fibres with different pore sizes. The amount of HCV particles in samples before and after filtration was determined by a quantitative reverse transcriptase polymerase chain reaction (PCR) method. Since there is no quantitative biological assay for HCV, except for that in chimpanzees, the HCV titre obtained from the PCR method was used in an equation constructed previously for application to filtration experiments with a flavivirus which is distantly related to HCV. The particle was estimated to be between 30 and 38 nm in diameter, although the possibility remained that larger HCV particles or HCV aggregates with a diameter of more than 39 nm might exist. Double-step filtration through microporous cellulose fibres with a pore size of 35 nm reduced the HCV content to below levels detectable by our PCR method, indicating that it is possible to eliminate HCV particles by simple filtration techniques.
to be continued
mb
Tazuko Yuasa1, Gen Ishikawa2, Sei-ichi Manabe2, Sadayoshi Sekiguchi3, Kenji Takeuchi1 and Tatsuo Miyamura1
1 Laboratory of Hepatitis Viruses II, Department of Enteroviruses, National Institute of Health, 2-10-35 Kamiosaki, Shinagawa-ku, Tokyo 141
2 Asahi Chemical Industries Co. Ltd., 1-1-1 Uchisaiwaicho, Chiyoda-ku, Tokyo 100
and3 Hokkaido Red Cross Blood Center, Yamanote 2-2, Nishi-ku, Sapporo 063, Japan
To estimate the particle size of hepatitis C virus (HCV), a major causative agent of post-transfusion non-A, non-B hepatitis, we filtered plasma or serum samples through microporous cellulose fibres with different pore sizes. The amount of HCV particles in samples before and after filtration was determined by a quantitative reverse transcriptase polymerase chain reaction (PCR) method. Since there is no quantitative biological assay for HCV, except for that in chimpanzees, the HCV titre obtained from the PCR method was used in an equation constructed previously for application to filtration experiments with a flavivirus which is distantly related to HCV. The particle was estimated to be between 30 and 38 nm in diameter, although the possibility remained that larger HCV particles or HCV aggregates with a diameter of more than 39 nm might exist. Double-step filtration through microporous cellulose fibres with a pore size of 35 nm reduced the HCV content to below levels detectable by our PCR method, indicating that it is possible to eliminate HCV particles by simple filtration techniques.
to be continued
mb
Yes, I'm a Sonic Care man myself. But, I have used natural boar bristles on my teeth as well as my horses - the horse brush was bigger though. I also use a boar bristle brush on my cars now that I think about it. Swine does come in handy.
Mike
Mike
MikeS-------------$1 for a toothbrush? I guess you're not a natural boar bristle man - but that sounds cheap for plastic even if it was a decade ago-----------
The only natural boar bristle brushes that I buy are horse brushes LOL. I'm with Trin on this one, sonic care
The only natural boar bristle brushes that I buy are horse brushes LOL. I'm with Trin on this one, sonic care
RE:....many have had hepatitis C for a number of years without knowing it, and still have not spread it to family members...
This was a very striking observation to me, and seems to speak volumes. To me it says, take care to clean up spilled blood, but don't obsess about transmission to others. Now that I'm thinking of it, our skin IS a great barrier to multitudes of bacteria and viruses, and unless someone near me has a cut, AND I didn't take care to clean up blood, AND they happen to touch it, WITH the hand with an open wound.... seems needless to say transmission isn't likely without blood to blood contact.
IMHO...which is pretty unlearned about this topic.
This was a very striking observation to me, and seems to speak volumes. To me it says, take care to clean up spilled blood, but don't obsess about transmission to others. Now that I'm thinking of it, our skin IS a great barrier to multitudes of bacteria and viruses, and unless someone near me has a cut, AND I didn't take care to clean up blood, AND they happen to touch it, WITH the hand with an open wound.... seems needless to say transmission isn't likely without blood to blood contact.
IMHO...which is pretty unlearned about this topic.
You know what they say Jim - talk's cheap...most of the time anyway.
You're right about the cost but sometimes you gotta either shoot big or stay home.
Mike
You're right about the cost but sometimes you gotta either shoot big or stay home.
Mike
My electric toothbrush is a Sonic. Replacement head costs about $30 x 30 days = $900 (crown) x 6 months = $5400 (3 implants)
mike, you can change these every tooth and still come out cheaper than the way you did it LOL
http://venturesix.com/store/index.php?keywords=cheap%20toothbrushes&creative=3457814929&gclid=CP-Vl9zUxpoCFQKenAodVz34tA
http://venturesix.com/store/index.php?keywords=cheap%20toothbrushes&creative=3457814929&gclid=CP-Vl9zUxpoCFQKenAodVz34tA
$1 for a toothbrush? I guess you're not a natural boar bristle man - but that sounds cheap for plastic even if it was a decade ago.
I used an electric one so I just changed the head daily. Was that compulsive? I didn't think so at the time.
Mike
I used an electric one so I just changed the head daily. Was that compulsive? I didn't think so at the time.
Mike
just for the record i do not believe in changing toothbrushes during TX. I did not. but i know my gums bleed when i brush my teeth so i would not share a toothbrush with my child. I would rather be safe then sorry.
as far as i'm concerned i made my point and offered "my opinion" and this will be my last comment in this thread.
God Bless
I see that you've posted the whole article here now, including the editorial note at the end:
editorial note: there is no evidence that HCV can be spread by saliva or by contact with a toothbrush with HCV in saliva on it. What about dried blood on a toothbrush or on a razor at home or in a barber shop? These are fair concerns.
1. Right. No evidence that HCV can be spread by saliva
2. Something being a "fair concern" does not mean that it is an established mode-of-transit for the virus.
Whether we think it's a good idea to change toothbrushes often doesn't mean there is any basis in fact/research to support it. Presenting something as fact when it is opinion is wrong. Being prudent can be very right.
editorial note: there is no evidence that HCV can be spread by saliva or by contact with a toothbrush with HCV in saliva on it. What about dried blood on a toothbrush or on a razor at home or in a barber shop? These are fair concerns.
1. Right. No evidence that HCV can be spread by saliva
2. Something being a "fair concern" does not mean that it is an established mode-of-transit for the virus.
Whether we think it's a good idea to change toothbrushes often doesn't mean there is any basis in fact/research to support it. Presenting something as fact when it is opinion is wrong. Being prudent can be very right.
One controversial source of infection for hepatitis C virus (HCV) involves the sharing of
contaminated implements, such as straws or spoons, used to nasally inhale cocaine and
other powdered drugs. An essential precondition for this mode of transmission is the
presence of HCV in the nasal secretions of intranasal drug users.
Methods
Blood and nasal secretion samples were collected from five plasma-positive chronic
intranasal drug users and tested for HCV RNA using RT-PCR.
Results
HCV was detected in all five blood samples and in the nasal secretions of the subject with
the highest serum viral load.
Conclusions
This study is the first to demonstrate the presence of HCV in nasal secretions. This
finding has implications for potential transmission of HCV through contact with
contaminated nasal secretions.
Transmission of HCV is known to occur through contact with contaminated blood, most
notably in the context of injection drug use, transfusion of blood products prior to 1992,
chronic hemodialysis, occupational exposure to blood, and nosocomial and perinatal
exposure. In addition, several studies have reported low levels of suspected sexual and
household transmission of HCV [2].
Although much is known about the routes of HCV transmission, nearly 15% of infected
individuals report no identifiable source of exposure. Unexplained cases are particularly
high among drug-users who have no history of injection risk and no other identifiable risk
factors [3]. One hypothesis that might account for the high number of unexplained HCV
infections among noninjection drug-users was proposed by researchers at the US National
Institutes of Health (NIH), who identified intranasal cocaine use as a significant risk
factor for HCV among volunteer blood donors [4]. They reasoned that HCV might be
transmitted through contaminated implements, such as straws or spoons, that are
commonly used to nasally inhale powdered drugs, including heroin, cocaine, and
methamphetamines. Chronic nasal inhalation of these substances (including the
adulterants they contain) can cause tissue deterioration and bleeding of nasal membranes.
Implements inserted into an eroded nasal cavity may come into contact with HCV-
infected mucus or blood, which may then be transmitted to an uninfected individual
sharing the same implement. The debate regarding this potential mode of transmission
intensified when the National Heart, Lung and Blood Institute (NHLBI) Retrovirus
Epidemiology Donor Study (REDS) was unable to confirm intranasal drug inhalation as
an independent risk factor for HCV [5]. These conflicting reports prompted the American
Association of Blood Banks (AABB) to add, and then shortly thereafter remove,
intranasal cocaine use from their list of criteria used to screen potential blood donors. A
subsequent review of the literature found serious methodological limitations with both the
NIH and NHLBI/REDS studies [6]. Although HCV has been detected in the saliva,
semen, and other nonserological fluids of some plasma-positive patients [7], no
virological studies have been undertaken to determine whether HCV is present in the
nasal secretions of intranasal drug users, a necessary precondition for internasal viral
transmission. Here, we report preliminary findings on the detection of HCV RNA in the
nasal secretions of plasma-positive chronic drug sniffers.
References Results and discussionPrevious studies have demonstrated the presence of
HCV in a wide variety of nonserological fluids [7,10]; for instance, HCV has been
detected in about 50% of saliva samples from plasma-positive individuals [11]. We
reasoned that HCV might be present in nasal secretions at a similar prevalence and would
therefore be detectable among a relatively small sample of viremic patients. Five
consecutive plasma-positive clinic patients were selected for study and each contributed
blood and nasal secretion samples for HCV RT-PCR analysis.
The RT-PCR results confirmed the presence of HCV in the blood of all five subjects. The
highest serum concentrations of viral RNA were detected in subjects 1 and 2 and the
lowest in subject 5 (see Fig. 1); these findings were consistent with patient record viral
loads. It is noteworthy that our assay detected HCV RNA in the serum of subject 5
(previously below the level of detection with commercially available assays), indicating
low-level viremia, and verifying the high sensitivity of our analysis.
Figure 1
HCV RNA detection from serum and nasal secretions of five intranasal drug users. A:
Ethidium bromide staining of DNA fragments; B: Southern blot hybridization
Significantly, HCV particles were also detected from the nasal secretions of subject 1
(Fig. 1). This subject, a 56-year-old African-American male, also exhibited the highest
HCV serum viral load (34 500 000 IU/mL). HCV was not detected in the nasal secretions
of the other four study subjects. This finding represents the first demonstration of the
presence of HCV RNA in nasal secretions.
Great care was taken to avoid sample contamination during all phases of the study. Blood
samples of known serology were collected from each of the five subjects and tested for
HCV RNA to confirm the validity of our laboratory procedures. The TRIzol assay used
on the nasal secretion samples in this study has been shown to be effective for RNA
isolation with a variety of other nonserological samples [11,12].
PA My hepatologist's pet is that the principal way people of my generation without known risk factors contracted HCV was via dental work.
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PA thoughtfully use the phrase "pet theory" and two things should be pointed out. First, the caveat is no known risk factors which immediately eliminates most probable means of transmission. And second, as stated, this is simply a pet theory because you will notice that dental work does not appear on either the CDC or NIH list posted by great bird, above. Personally, I would not be surprised that transmission has occurred, and even still does occur, in some dental offices. Or during other medical procedures per se.. I just don't see any evidence that it's a major cause of transmission, at any point in time.
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PA thoughtfully use the phrase "pet theory" and two things should be pointed out. First, the caveat is no known risk factors which immediately eliminates most probable means of transmission. And second, as stated, this is simply a pet theory because you will notice that dental work does not appear on either the CDC or NIH list posted by great bird, above. Personally, I would not be surprised that transmission has occurred, and even still does occur, in some dental offices. Or during other medical procedures per se.. I just don't see any evidence that it's a major cause of transmission, at any point in time.
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