Some evidence for the presence of hepatitis viruses A, B and C in oral fluids

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Viral hepatitis is caused by five distinct viruses (A-F) and they represent a significant worldwide healthcare problem. Three of the viruses hepatitis A, B and C (HAV, HBV, HCV) are the most common causes. Recently, there has been renewed interest in whether oral fluids can be considered as a source of viral hepatitis transmission.  There is also interest in whether whole saliva, in particular may be a useful source for viral detection as part of the diagnosis and monitoring of viral hepatitis. The main aim of this review was to assess the current data concerning the possible carriage of the hepatitis A, B and C viruses within saliva and gingival crevicular fluid.

The authors searched the  Cochrane, Medline, Embase and Scopus databases. They included review articles case–control studies, investigative studies (before-and-after treatment), observational studies and surveys and reports on viral hepatitis transmission probability by oral fluid. The results were limited to published material after 2000.

The authors included 51 studies in the review and present a narrative review of the findings for each of the 3 viruses.

The authors concluded

 There is some evidence that hepatitis viruses A, B and C are present in oral fluids, particularly whole saliva and gingival crevicular fluid and may thus be possible sources of viral detection in clinical diagnosis and monitoring. However, the data are inconsistent and warrant the need for well-planned longitudinal studies to explore the precise frequency of oral carriage of such viruses and to determine the virological and host factors that may influence the oral presence of hepatitis A, B and C viruses.

Mahboobi N, Porter SR, Karayiannis P, Alavian SM. Oral fluid and hepatitis A, B and C: A literature review. J Oral Pathol Med. 2011 Dec 22. doi:10.1111/j.1600-0714.2011.01123.x. [Epub ahead of print] PubMed PMID: 22188507.


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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. He is a former editor of the Evidence-Based Dentistry Journal, the chief blogger for the Dental Elf website and a past president of the British Association for the Study of Community Dentistry. He has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Retired from the NHS he is currently a part-time senior lecturer at Dundee Dental School.

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