Cross Infection in Dental Clinic Hepatitis B Virus HBV Sara AlGahtani,BDS Oral Microbiology Demonstrator
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Cross Infection in Dental Clinic Hepatitis B Virus
HBV
Sara AlGahtani,BDS Oral Microbiology Demonstrator
Introduction
HEPATITIS
Structure
HBeAg
Epidemiology
Prevalence of HBV in Saudi Arabia is as high as 8% .
G.Gasim ,2013
There is higher prevalence of HBV infection in Asia and Africa (8-15%) than America and Western Europe (<2%).
K.Oakes ,2014
Epidemiology
Viral hepatitis is 2nd common viral infection in KSA. Prevalence according to El-beltagy,2008 is as follows :
Abdo et al , 2012
Central South west East North west
1.5% 5.4% 6.7% 3%
Transmission
HBV may be transmitted via Blood or Body fluids
Risk of contracting HBV
People at High Risk of Infection
HBV Survival
Pathogenesis and Clinical Feastures
High titers of HBV reaching 108 -1011 virions /ml
Fever, Malaise, Nausea,Vomiting ,Dark Urine, Pale fatty stool, Jaundice
States of the Disease
Laboratory Diagnosis
Biochemistry: Bilirubin Hepatic enzymes : GPT , Alkaline Phosphatase
Serology (Hepatitis Markers): HBsAg – Acute or Chronic(Carrier) Infection Anti-HBsAg – Immunity due to Vaccine or Previous Exposure HBeAg – High Infectivity Anti-HBeAg – Low Infectivity and Recovery Anti-HBcAg – Acute(Recent) or Chronic, Previous Exposure
Laboratory Diagnosis
With Recovery
Laboratory Diagnosis
Chronic
State
Precautions And Prevention
Careful history
Blood Tests
PPE
Vaccination
HBV Inactivation
Autoclaving for 15 min. at 1210C
Dry Heat for 1 hour at 1500C
Aqueous Formaldehyde for 12 hours at 16%
Sodium Hypochlorite for 30 min. at 1%
Immunization And Vaccination
Passive Immunization: 1-Immune Serum globulin ISG 2-Hepatitis B Immune Globulin HBIG Needle Injury or Infants in 3rd trimester
Active Immunization (Vaccine): 1-Plasma-derived Vaccine 2-Recombinant DNA Vaccine
Treatment And Dental Management
Medical Management: Acute Vs. Chronic
Dental Management: Active Hepatitis
History of HepatitisHepatitis CarrierSigns and Symptoms of HepatitisInfected Dentist
Practice
Management Status Anti-HBcAg HBeAg Anti-HBsAg HBsAg
Acute Infection
Active Hepatitis– Highly Infectious+ + +
+ +
++
+
_
_ _
_ _
_ _ _
Resolved Infection
History of Hepatitis-Immune
Chronic Infection
Carrier of Hepatitis-Infectious
Vaccinated Immune
References
Little, Dental Management of the Medically Compromised Patient,7th edition Essential Microbiology for Dentistry 3RD EDITIONHepatitis B: prevalence and Pathophysiology ,Kathyrn Oakes,Nursing Times 12.02.14 / Vol 110 No 7 / www.nursingtimes.net Hepatitis B virus in the Arab world: Where do we stand?,Gasim Gasim, Arab Journal of Gastroenterology 14 (2013) 35–43Epidemiology of Viral Hepatitis in Saudi Arabia:Are We Off the Hook?, Abdo et al , The Saudi Journal ofGastroenterology, 349 Volume 18, Number 6, Dhul Hijjah 1433H November 2012Several Resources of Figures.
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