DENTAL CLINICS: A RESERVOIR FOR HEPATITIS C VIRUS

Nosocomial transmission of hepatitis C virus (HCV) is well established, however the role of dental care in HCV transmission has been speculated but particularly difficult to quantify. This study investigated the potential for nosocomial transmission of HCV in dental clinics in a high HCV prevalence, middle-income country.  Dental health care workers (DHCWs) in 13 clinics in 3 cities were invited to participate. After informed consent was obtained, the DHCWs were asked to provide a blood sample to test for anti-HCV and complete a questionnaire that included questions on risk behaviors. A second sample of dental clinics was recruited to conduct environmental testing for HCV RNA. Among the 244 DHCWs invited to participate in the study, 196 (80.3%) enrolled including 115 doctors, 49 nurses and 32 dental residents. The seroprevalence of anti-HCV among DHCWs was 4%. Of the 46 private dental clinics invited to participate, 37 (80.4%) dental clinics agreed to allow the environmental study. Overall, 23 (62.2%) clinics had HCV RNA detected in at least one location. The most frequently contaminated location was the suction unit with HCV RNA retrieved from 14 (37.8%) clinics, followed by contaminated samples from the general dental room in 9 (24.3%) clinics. Given that HCV RNA can be viable for up to six weeks, without fastidious attention to infection control procedures, patients may be exposed to contaminated dental equipment and nosocomial transmission can occur.