Viral Hepatitis Prevention Training for Dentists

Objectives of the Module

• Understand clinical picture, epidemiology, transmission, and prevention of Hepatitis C virus (HCV).

Global Prevalence of Hepatitis C

• Approximately 170 million HCV carriers worldwide.
• New cases estimated at 3-4 million annually.
• Significant prevalence in various regions:
  • Mediterranean: 20 million
  • South East Asia: 30 million
  • Africa: 32 million
  • USA: 9 million

HCV Genotypes

• 11 genotypes exist with various subtypes.
• Genotype 4 is prevalent in Saudi Arabia (62.9%).
• In Europe and America, Genotype 1 is common (24.8%).
• Types 1 and 4 are associated with poor therapy response.

Natural History of HCV Infection

• Acute phase leads to:
  • 15% resolved infections.
  • 85% chronic infections, with 80% remaining stable.
• 20% of chronic cases progress to cirrhosis.
• Complications can include hepatocellular carcinoma (HCC) and potential for liver transplant or death.

Transmission of Hepatitis C

• HCV is not spread through casual contact (kissing, hugging, sneezing).
• Occupational transmission occurs, with an average incidence of 1.8% from needlestick injuries.
• Low prevalence among healthcare workers, significantly lower than for HBV.

Recognized HCV Transmission Settings

• Primarily linked to outbreaks in:
  • Chronic hemodialysis centers.
  • Hospital and outpatient settings.
• Unsafe injection practices increase risk (reuse of syringes).

Perinatal and Sexual Transmission

• Perinatal transmission occurs in 6% of deliveries from HCV-RNA positive mothers.
  • Rate increases to 17% with co-infection of HIV.
• Sexual transmission is low, often linked to high-risk behaviors, with efficient male-to-female transmission.

Household Transmission

• Rare but may occur via blood exposure through contaminated personal items (razors, toothbrushes).

Prevention Strategies

• Implement rigorous screening and testing for blood donors.
• Employ virus inactivation processes for plasma products.
• Provide risk-reduction counseling and vaccinations for Hepatitis A/B.

Risk Management for HCV

• Identification and management of high-risk individuals.
• Regular medical evaluations for HCV-positive individuals to prevent liver damage and further transmission.

Postexposure Protocol for HCV

• Immunoglobulin and antivirals not recommended for prophylaxis after exposure.
• Follow-up testing recommended for workers exposed to HCV-positive blood.

Thank You

• Acknowledgment for engagement in the content and learning process.

This training module focuses on the prevention of viral hepatitis infections, particularly Hepatitis C, targeting dental healthcare professionals. Led by Dr. Haidar Husham, the course will cover essential practices for safeguarding against infection in dental settings, ensuring a comprehensive understanding of the risks and preventive measures.