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?
why have you removed the links to studies I posted two times? These links were from realible sources and could help someone with HCV, especially someone that just finds out they have it. People deserve to know there are other ways of transmitting HCV instead of the IDU junkie stigma attached to the disease. Here are the actual articles.
DDW Liver Conference
San Francisco,
HEPATITIS C - TRANSMISSION BY TOOTHBRUSHES: A MYTH OR A REAL POSSIBILITY?
Reported by Jules Levin
Guntram Lock, Martin Dirscherl, Florian Obermeier, Cornelia M. Gelbmann, Claus Hellerbrand, Antje Knoell, Juergen Schoelmerich, Wolfgang Jilg, Regensburg, Germany
Introduction: Up to 40% of patients with chronic hepatitis C have no obvious risk factor for the disease. Unconventional ways of transmission such as for example infection by tattooing or sharing of possibly infected household objects have been discussed to play a role for these community acquired forms. Thus, patients with hep. C are advised to take care not to share objects like razors, nail-scissors or toothbrushes with their household members. In this study, we prospectively examined the contamination of toothbrushes in patients with chronic hep. C as a model for a possible unconventional way of transmission.
Patients and methods: 30 consecutive patients with chronic hep. C were included in the study. Around 2 ml of saliva were obtained before and after brushing the teeth under controlled conditions for 2 minutes. After toothbrushing, the toothbrush was rinsed in 2 ml of NaCl. RNA was isolated with the QIAmp Viral RNA mini Kit (Qiagen) and HCV-RNA was detected by the COBAS AMPLICOR HCV - Test v2.0. Results were qualitatively graded as positive or negative. Oral hygiene was classified as good, fair or bad, and the parodontose bleeding index (PBI) was determined by a dentist. Clinical, biochemical and histological parameters were related to the HCV results in saliva and toothbrush rinsing water.
Results: In 9/30 patients (30%), the "native" saliva (i.e. before toothbrushing) was positive for HCV-RNA, and in 11/29 patients (37.9%) saliva after toothbrushing contained HCV - RNA. In as many as 12/30 (40%) specimen of the rinsing waters of the toothbrushes HCV - RNA was positive. In 6 of these 12 patients, the "native" saliva had been negative for HCV RNA. Patients with HCV - RNA positive toothbrush rinsing water showed no significant differences to patients with HCV RNA negative rinsing water in respect to oral hygiene, PBI, histological grading or staging, coagulation parameters, ALT, bilirubin and quantitative HCV - viral load in the serum.
Conclusion: With sufficiently sensitive methods, a contamination with HCV-RNA can be detected at a large portion of toothbrushes used by hep. C patients. In spite of the low infection risk usually published for household contacts, transmission by contaminated every-day`s household objects appears to be possible. Considering the great epidemiological importance of hep. C, further examinations and maybe even legal instructions concerning publically used possibly infected objects such as razors in barbershops appear indicated.
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.
DDW Liver Conference
San Francisco,
HEPATITIS C - TRANSMISSION BY TOOTHBRUSHES: A MYTH OR A REAL POSSIBILITY?
Reported by Jules Levin
Guntram Lock, Martin Dirscherl, Florian Obermeier, Cornelia M. Gelbmann, Claus Hellerbrand, Antje Knoell, Juergen Schoelmerich, Wolfgang Jilg, Regensburg, Germany
Introduction: Up to 40% of patients with chronic hepatitis C have no obvious risk factor for the disease. Unconventional ways of transmission such as for example infection by tattooing or sharing of possibly infected household objects have been discussed to play a role for these community acquired forms. Thus, patients with hep. C are advised to take care not to share objects like razors, nail-scissors or toothbrushes with their household members. In this study, we prospectively examined the contamination of toothbrushes in patients with chronic hep. C as a model for a possible unconventional way of transmission.
Patients and methods: 30 consecutive patients with chronic hep. C were included in the study. Around 2 ml of saliva were obtained before and after brushing the teeth under controlled conditions for 2 minutes. After toothbrushing, the toothbrush was rinsed in 2 ml of NaCl. RNA was isolated with the QIAmp Viral RNA mini Kit (Qiagen) and HCV-RNA was detected by the COBAS AMPLICOR HCV - Test v2.0. Results were qualitatively graded as positive or negative. Oral hygiene was classified as good, fair or bad, and the parodontose bleeding index (PBI) was determined by a dentist. Clinical, biochemical and histological parameters were related to the HCV results in saliva and toothbrush rinsing water.
Results: In 9/30 patients (30%), the "native" saliva (i.e. before toothbrushing) was positive for HCV-RNA, and in 11/29 patients (37.9%) saliva after toothbrushing contained HCV - RNA. In as many as 12/30 (40%) specimen of the rinsing waters of the toothbrushes HCV - RNA was positive. In 6 of these 12 patients, the "native" saliva had been negative for HCV RNA. Patients with HCV - RNA positive toothbrush rinsing water showed no significant differences to patients with HCV RNA negative rinsing water in respect to oral hygiene, PBI, histological grading or staging, coagulation parameters, ALT, bilirubin and quantitative HCV - viral load in the serum.
Conclusion: With sufficiently sensitive methods, a contamination with HCV-RNA can be detected at a large portion of toothbrushes used by hep. C patients. In spite of the low infection risk usually published for household contacts, transmission by contaminated every-day`s household objects appears to be possible. Considering the great epidemiological importance of hep. C, further examinations and maybe even legal instructions concerning publically used possibly infected objects such as razors in barbershops appear indicated.
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.
portann, great point. dental work also has to be included as possibly one of the top means of transmission. Probably a greater chance then sharing toothbrushes.
Greatbird, didn't mean to ruffle your feathers and by no way was I questioning your hygine. The way your original post sounded was sharing toothbrushes was no big deal. That is why I asked if you would let a family member use your toothbrush. Since you didn't answer the question I will assume you would not have a problem with it.
Lets just leave my "opinion" as this: NO one really knows how many other ways this disease can spread so why not just be extra careful if you have it. By this I mean if there is a remote possibility use common sense and avoid exposure.
Greatbird, didn't mean to ruffle your feathers and by no way was I questioning your hygine. The way your original post sounded was sharing toothbrushes was no big deal. That is why I asked if you would let a family member use your toothbrush. Since you didn't answer the question I will assume you would not have a problem with it.
Lets just leave my "opinion" as this: NO one really knows how many other ways this disease can spread so why not just be extra careful if you have it. By this I mean if there is a remote possibility use common sense and avoid exposure.
s/b: "when transmission was often via medical and dental offices in the absence of known risk factors such as transfusion or IDU."
s/b: "I would call those routes some of the top ones for transmission at that time, barring known risk factors like transfusion and IDU."
s/b: "I would call those routes some of the top ones for transmission at that time, barring known risk factors like transfusion and IDU."
s/b 'when transmission was often via medical and dental offices' in the absence of known risk factors such as transfusion or IDU.
My hepatologist's pet theory is that the principal way people of my generation without known risk factors contracted HCV was via dental work.
He never mentioned toothbrushes but it's prudent to not share them, although most of us did. My husband and I inadvertently still do, despite our best laid plans.
Today, I believe IDU may be one of the main sources of HCV transmission but it was not the case in my generation, when transmission was often via medical and dental offices. I probably got mine through gamma globulin shots or a backstreet college deal to extract my impacted wisdom teeth at a rock bottom price. (In both cases, I got wildly sick.)
I would call those routes some of the top ones for transmission in that time period.
He never mentioned toothbrushes but it's prudent to not share them, although most of us did. My husband and I inadvertently still do, despite our best laid plans.
Today, I believe IDU may be one of the main sources of HCV transmission but it was not the case in my generation, when transmission was often via medical and dental offices. I probably got mine through gamma globulin shots or a backstreet college deal to extract my impacted wisdom teeth at a rock bottom price. (In both cases, I got wildly sick.)
I would call those routes some of the top ones for transmission in that time period.
I guess you have no problem with sharing a toothbrush with a family member?
---
OMG. Why ever would you say that? I posted no information about my own personal hygenic habits, and your suggesting this is rather insulting.
I simply responded to your opinion and misstatements about a study.
Regardless of your opinions and feelings that "We can not just let people think the only way they can get it is IDU ?" the proper thing to do is to point someone to the CDC or NIH for the information.
----
According to the CDC:
http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#section2
How is HCV transmitted?
HCV is transmitted primarily through large or repeated percutaneous (i.e., passage through the skin) exposures to infectious blood, such as
* Injection drug use (currently the most common means of HCV transmission in the United States)
* Receipt of donated blood, blood products, and organs (once a common means of transmission but now rare in the United States since blood screening became available in 1992)
* Needlestick injuries in healthcare settings
* Birth to an HCV-infected mother
HCV can also be spread infrequently through
* Sex with an HCV-infected person (an inefficient means of transmission)
* Sharing personal items contaminated with infectious blood, such as razors or toothbrushes (also inefficient vectors of transmission)
* Other healthcare procedures that involve invasive procedures, such as injections (usually recognized in the context of outbreaks)
---
According to the NIH:
http://digestive.niddk.nih.gov/ddiseases/pubs/hepc_ez/#2
How could I get hepatitis C?
Hepatitis C is spread by contact with an infected person's blood.
You could get hepatitis C by
Man offering another man a syringe.
You could get hepatitis C by sharing drug needles.
* sharing drug needles
* getting pricked with a needle that has infected blood on it (hospital workers can get hepatitis C this way)
* having sex with an infected person, especially if you or your partner has other sexually transmitted diseases
* being born to a mother with hepatitis C
In rare cases, you could get hepatitis C by
* getting a tattoo or body piercing with unsterilized, dirty tools
You can NOT get hepatitis C by
* shaking hands with an infected person
* hugging an infected person
* kissing an infected person
* sitting next to an infected person
---
OMG. Why ever would you say that? I posted no information about my own personal hygenic habits, and your suggesting this is rather insulting.
I simply responded to your opinion and misstatements about a study.
Regardless of your opinions and feelings that "We can not just let people think the only way they can get it is IDU ?" the proper thing to do is to point someone to the CDC or NIH for the information.
----
According to the CDC:
http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#section2
How is HCV transmitted?
HCV is transmitted primarily through large or repeated percutaneous (i.e., passage through the skin) exposures to infectious blood, such as
* Injection drug use (currently the most common means of HCV transmission in the United States)
* Receipt of donated blood, blood products, and organs (once a common means of transmission but now rare in the United States since blood screening became available in 1992)
* Needlestick injuries in healthcare settings
* Birth to an HCV-infected mother
HCV can also be spread infrequently through
* Sex with an HCV-infected person (an inefficient means of transmission)
* Sharing personal items contaminated with infectious blood, such as razors or toothbrushes (also inefficient vectors of transmission)
* Other healthcare procedures that involve invasive procedures, such as injections (usually recognized in the context of outbreaks)
---
According to the NIH:
http://digestive.niddk.nih.gov/ddiseases/pubs/hepc_ez/#2
How could I get hepatitis C?
Hepatitis C is spread by contact with an infected person's blood.
You could get hepatitis C by
Man offering another man a syringe.
You could get hepatitis C by sharing drug needles.
* sharing drug needles
* getting pricked with a needle that has infected blood on it (hospital workers can get hepatitis C this way)
* having sex with an infected person, especially if you or your partner has other sexually transmitted diseases
* being born to a mother with hepatitis C
In rare cases, you could get hepatitis C by
* getting a tattoo or body piercing with unsterilized, dirty tools
You can NOT get hepatitis C by
* shaking hands with an infected person
* hugging an infected person
* kissing an infected person
* sitting next to an infected person
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