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Topic Summary
Nearly 4 million Americans are infected with Hepatitis C virus (HCV) — four times the number infected with HIV — according to the cover story of the May 1999 issue of The Journal of the American Dental Association. The article, "Risk and Prevention of Hepatitis C Virus Infection: Implications for Dentistry," reviews the natural history, prevention, diagnosis, treatment, and transmission of HCV infection, with particular attention to the dental profession.
The hepatitis C virus was discovered only recently, in the late 1980s. Chronic hepatitis may not be detected for several decades, until the patient experiences symptoms of advanced liver disease, such as cirrhosis or liver cancer. Chronic liver disease associated with HCV infection leads to an estimated 8,000 to 10,000 deaths each year, and HCV is the number one reason for liver transplantation in the United States.
HCV is most prevalent among people with large or frequent exposure to blood, including people with hemophilia and injecting drug users. People who received blood transfusions before 1990 and patients undergoing dialysis treatment also show a higher-than-average prevalence of HCV infection. (See the Related Links section for links to non-ADA Web sites concerned with HCV and related issues.)
Dentists and dental professionals are no more likely to be infected than the general population, and their risk of becoming infected at work appears to be very low. Still, because (1) no effective vaccine or post-exposure prophylaxis is available for HCV, (2) the rate of chronic infection is high, and (3) treatment for HCV infection is of limited efficacy, HCV is a concern for health care workers — including dental workers — who may come into contact with blood.
As a result, it is especially important to prevent the transmission of HCV. In health care settings, prevention relies on the use of universal precautions, including barrier precautions (e.g., gloves, masks, and protective eyewear) and the safe handling of sharp instruments. (See the Additional Resources section for materials on HCV and infection control found elsewhere on ADA.org.)
The ADA has provided resources as well as links to non-ADA materials elsewhere on the Internet for dentists and dental workers who have HCV or are concerned about HCV infection. A selected bibliography provided by the ADA Library also is available, and ADA members may order a reference package containing the materials in this bibliography.
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