self-reinfection while on TX

[Charismatic]

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?

[jmjm530]

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

[mikesimon]

$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

[copyman]

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

[GreatBird]

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.

[copyman]

  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].

[jmjm530]

PA My hepatologist's pet is that the principal way people of my generation without known risk factors contracted HCV was via dental work.
------------------------------------------------------------
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.