Overview for HBV infection for undergraduate dental students

1. Cross Infection in
Dental Clinic
Hepatitis B Virus
HBV
Sara AlGahtani,BDS
Oral Microbiology Demonstrator

2. Introduction
HEPATITIS

3. Structure
HBeAg

4. 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

5. Epidemiology
Viral hepatitis is 2nd common viral infection in KSA.
Prevalence according to El-beltagy,2008 is as
follows :
Abdo et al , 2012
CentralSouth westEastNorth west
1.5%5.4%6.7%3%

6. Transmission
HBV may be transmitted via Blood or Body fluids
Risk of contracting HBV
People at High Risk of Infection
HBV Survival

7. 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

8. 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

9. Laboratory Diagnosis
With Recovery

10. Laboratory Diagnosis
Chronic
State

11. Precautions And Prevention
Careful history
Blood Tests
PPE
Vaccination

12. 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%

13. 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

14. Treatment And Dental Management
Medical Management:
Acute Vs. Chronic
Dental Management:
Active Hepatitis
History of Hepatitis
Hepatitis Carrier
Signs and Symptoms of Hepatitis
Infected Dentist

15. Practice
ManagementStatusAnti-HBcAgHBeAgAnti-HBsAgHBsAg
Acute
Infection
Active Hepatitis –
Highly Infectious
+ + +
+ +
+
+
+
_
_ _
_ _
_ _ _
Resolved
Infection
History of
Hepatitis-
Immune
Chronic
Infection
Carrier of
Hepatitis-
Infectious
Vaccinated Immune

16. References
 Little, Dental Management of the Medically Compromised
Patient,7th edition
 Essential Microbiology for Dentistry 3RD EDITION
Hepatitis 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) 35–43
Epidemiology of Viral Hepatitis in Saudi Arabia:
Are We Off the Hook?, Abdo et al , The Saudi Journal of
Gastroenterology, 349 Volume 18, Number 6, Dhul Hijjah 1433H
November 2012
Several Resources of Figures.