Bloodborne infections in dental practice: prevalence of markers and phylogenetic analysis of circulating strains

Cover Page

Cite item

Full Text

Abstract

Introduction. Human immunodeficiency virus (HIV) and hepatitis B (HBV) and C (HCV) viruses remain among the most dangerous bloodborne pathogens, posing a significant global public health threat.

The aim of our work was to assess the prevalence of HIV, HBV, and HCV markers among dental patients and provide a molecular genetic characterization of the identified pathogens.

Materials and methods. We analyzed 497 plasma samples from individuals who sought dental care in St. Petersburg for serological and molecular markers of target infections. Viral genome fragments were sequenced and analyzed when molecular markers were detected.

Results. Anti-HCV were detected in 3.8% (19/497) of participants, with HCV RNA in 1% (5/497). HIV Ag/Ab was found in 1.2% (6/497), with two cases (0.4%, 2/497) confirmed by immunoblot; no HIV RNA was detected. HBsAg prevalence was 2.4% (12/497), with anti-HBs in 32.0% (159/497) and anti-HBc in 25.6% (127/497) of participants. Significant age-related trends were observed: anti-HBs predominated in younger groups while anti-HBc was more frequent in older individuals. HBV DNA was detected in 3.8% (19/497) of cases, including 1.8% (9/497) HBsAg-negative infections. Predominant in the Russian Federation viral genotypes were identified (HCV: 1b, 2a, 3a; HBV: D1, D2, D3). One HCV isolate carried mutations associated with resistance to dasabuvir, sofosbuvir, and voxilaprevir. Multiple HBV isolates harbored concurrent mutations causing diagnostic escape (HBsAg-negative variants), reduced vaccine efficacy, viral reactivation, and disease progression.

Conclusions. The study reveals high viral hepatitis prevalence among dental patients. Detection of drug-resistant HCV variants and immune-evading HBV strains underscores the need for enhanced molecular surveillance, improved diagnostic protocols, and strengthened infection control measures.

About the authors

Yulia V. Ostankova

St. Petersburg Pasteur Institute

Email: shenna1@yandex.ru
ORCID iD: 0000-0003-2270-8897

Cand. Sci. (Biol.), Senior Researcher at the Laboratory of Molecular Immunology, Head of the Laboratory of Immunology and Virology HIV Infection

Russian Federation, 197101, St. Petersburg

Elena N. Serikova

St. Petersburg Pasteur Institute

Email: elena.donetsk.serikova@mail.ru
ORCID iD: 0000-0002-0547-3945

Researcher, Laboratory of Immunology and Virology HIV Infection

Russian Federation, 197101, St. Petersburg

Alexandr N. Schemelev

St. Petersburg Pasteur Institute

Email: tvildorm@gmail.com
ORCID iD: 0000-0002-3139-3674

PhD, Junior Researcher, Laboratory of Immunology and Virology HIV Infection

Russian Federation, 197101, St. Petersburg

Ekaterina V. Anufrieva

St. Petersburg Pasteur Institute

Email: kate.an21@yandex.ru
ORCID iD: 0009-0002-1882-529X

Junior Researcher, Laboratory of Immunology and Virology HIV Infection

Russian Federation, 197101, St. Petersburg

Elena B. Zueva

St. Petersburg Pasteur Institute

Email: ezueva75@mail.ru
ORCID iD: 0000-0002-0579-110X

PhD, Biologist at the Department of Diagnostics of HIV Infection and AIDS-Associated Diseases

Russian Federation, 197101, St. Petersburg

Olga S. Kreidik

St. Petersburg State Budgetary Institution of Health «City Polyclinic No. 38»

Email: Kreidik@mail.ru
ORCID iD: 0009-0000-2061-7073

Dentist-surgeon, Аdult dental department

Russian Federation, 191015, St. Petersburg

Marina B. Kusevitskaya

St. Petersburg State Institution of Health «City Clinical Hospital No. 31»

Email: mbkus@mail.ru
ORCID iD: 0000-0002-7196-2595

PhD (in Medicine), obstetrician-gynecologist of the Department of Operative Gynecology

Russian Federation, 197110, St. Petersburg

Leonid Ya. Kusevitskiy

First St. Petersburg State I. Pavlov Medical University

Email: stomdoc@mail.ru
ORCID iD: 0000-0001-5739-5179

PhD, MD (Medicine), dentist-orthopedist of the highest qualification category, Professor of prosthodontics and materials science with orthodontics course

Russian Federation, 197022, St. Petersburg

Areg A. Totolian

St. Petersburg Pasteur Institute; First St. Petersburg State I. Pavlov Medical University

Author for correspondence.
Email: totolian@pasteurorg.ru
ORCID iD: 0000-0003-4571-8799

Academician of the Russian Academy of Sciences, PhD, MD (Medicine), Professor, Head at the Laboratory of Molecular Immunology, Director, head Department of Immunology

Russian Federation, 197101, St. Petersburg; 197022, St. Petersburg

References

  1. Salari N., Kazeminia M., Hemati N., Ammari-Allahyari M., Mohammadi M., Shohaimi S. Global prevalence of hepatitis C in general population: A systematic review and meta-analysis. Travel Med. Infect. Dis. 2022; 46: 102255. https://doi.org/10.1016/j.tmaid.2022.102255
  2. Mangkara B., Xaydalasouk K., Chanthavilay P., Kounnavong S., Sayasone S., Muller C.P., et al. Hepatitis B virus in Lao dentists: A cross-sectional serological study. Ann. Hepatol. 2020; 22: 100282. https://doi.org/10.1016/j.aohep.2020.10.010
  3. Abalkhail A., Kabir R., Elmosaad Y.M., Alwashmi A.S.S., Alhumaydhi F.A., Alslamah T., et al. Needle-stick and sharp injuries among hospital healthcare workers in Saudi Arabia: a cross-sectional survey. Int. J. Environ. Res. Public Health. 2022; 19(10): 6342. https://doi.org/10.3390/ijerph19106342
  4. Chen J.W., Wang J., Wang A.Q., Zhang J., Han L.H. Blood-borne occupation exposures in dental practice of medical staff: Status and protection. Chin. J. Ind. Hyg. Occup. Dis. 2020; 38(1): 29–32. https://doi.org/10.3760/cma.j.issn.1001-9391.2020.01.006
  5. Popova A.Yu., Gorbunova A.Yu., Ostankova Yu.V., Egorova S.A., Reingardt D.E., Ivanova A.R., et al. Herd immunity to hepatitis a virus in the Saint Petersburg and Leningrad region. Meditsinskaya immunologiya. 2025; 27(3): 625–42. https://doi.org/10.15789/1563-0625-HIT-3224 https://elibrary.ru/yqusbr (in Russian)
  6. Ostankova Yu.V., Serikova E.N., Semenov A.V., Totolian A.A. Method for hepatitis B virus DNA detecting in biological material at low viral load based on nested PCR with detection on three viral targets in real-time mode. Klinicheskaya laboratornaya diagnostika. 2022; 67(9): 530–7. https://doi.org/10.51620/0869-2084-2022-67-9-530-537 https://elibrary.ru/qndbzr (in Russian)
  7. Reingardt D.E., Ostankova Yu.V., Anufrieva E.V., Semenov A.V., Totolian A.A. Technique for detection significant nucleotide substitutions in target genes based on the methodology for detection hepatitis C virus’es resistance mutations. Klinicheskaya laboratornaya diagnostika. 2024; 69(4): 150–8. https://doi.org/10.51620/0869-2084-2024-69-4-150-158 https://elibrary.ru/oayxyq (in Russian)
  8. Ostankova Y.V., Semenov A.V., Zueva E.B., Totolian A.A. The first cases of hepatitis B virus subgenotype D4 detection in patients with chronic, acute, and occult hepatitis B in the Russian Federation. Molecular Genetics, Microbiology and Virology. 2020; 35(4): 221–8. https://doi.org/10.3103/S0891416820040072 https://elibrary.ru/bbamjw
  9. Crossley B.M., Bai J., Glaser A., Maes R., Porter E., Killian M.L., et al. Guidelines for Sanger sequencing and molecular assay monitoring. J. Vet. Diagn. Invest. 2020; 32(6): 767–75. https://doi.org/10.1177/1040638720905833
  10. Kleffe J., Weißmann R., Schmitzberger F.F. Single nucleotide polymorphisms caused by assembly errors. Genomics Insights. 2010; 3: 1–8. https://doi.org/10.4137/GEI.S3653
  11. Chieochansin T., Puenpa J., Poovorawan Y. Phylogenetic molecular evolution and recombination analysis of complete genome of human parechovirus in Thailand. Sci. Rep. 2021; 11(1): 8572. https://doi.org/10.1038/s41598-021-88124-8
  12. Liu Y., Li J., Wu Q. Short tandem repeats of human genome are intrinsically unstable in cultured cells in vivo. Gene. 2023; 877: 147539. https://doi.org/10.1016/j.gene.2023.147539
  13. Brichler S., Lagathu G., Chekaraou M.A., Le Gal F., Edouard A., Dény P., et al. African, Amerindian and European hepatitis B virus strains circulate on the Caribbean Island of Martinique. J. Gen. Virol. 2013; 94(Pt. 10): 2318–29. https://doi.org/10.1099/vir.0.055459-0
  14. Săndulescu M., Nicolescu M.I., Funieru C., Şahin G.Ö., Săndulescu O. Exposure to biological fluids in dental practice-narrative review on appropriate risk assessment to guide post-exposure management. Pathogens. 2023; 12(7): 968. https://doi.org/10.3390/pathogens12070968
  15. Amkhadova M.A., Bogovskaya E.A., Remizova E.A., Boroday A. Infectious diseases related to the provision of medical care. Actual problems for health careers and patients. Meditsinskii alfavit. 2020; (12): 54–8. https://doi.org/10.33667/2078-5631-2020-12-54-58 https://elibrary.ru/rllxbb (in Russian)
  16. Garus-Pakowska A., Górajski M., Szatko F. Knowledge and attitudes of dentists with respect to the risks of blood-borne pathogens – a cross-sectional study in Poland. Int. J. Environ. Res. Public Health. 2017; 14(1): 69. https://doi.org/10.3390/ijerph14010069
  17. Corrêa R.d.O., de Arruda J.A.A., Gomes A.I.F., Aguiar E.G., e Ferreira E.F., de Magalhães C.S., et al. Perceptions and conducts of oral and maxillofacial surgeons during the COVID-19 pandemic: A qualitative study. PLoS One. 2023; 18(6): e0286853. https://doi.org/10.1371/journal.pone.0286853
  18. Sebastiani F.R., Dym H., Kirpalani T. Infection control in the dental office. Dent. Clin. North Am. 2017; 61(2): 435–57. https://doi.org/10.1016/j.cden.2016.12.008
  19. Sotomayor-Castillo C., Li C., Kaufman-Francis K., Nahidi S., Walsh L.J., Liberali S.A., et al. Australian dentists’ knowledge, preparedness, and experiences during the COVID-19 pandemic. Infect Dis. Health. 2022; 27(1): 49–57. https://doi.org/10.1016/j.idh.2021.10.001
  20. Ayatollahi J., Ayatollahi F., Ardekani A.M., Bahrololoomi R., Ayatollahi J., Ayatollahi A., et al. Occupational hazards to dental staff. Dent. Res. J. (Isfahan). 2012; 9(1): 2–7. https://doi.org/10.4103/1735-3327.92919
  21. Candotti D., Laperche S. Hepatitis B virus blood screening: need for reappraisal of blood safety measures? Front. Med. (Lausanne). 2018; 5: 29. https://doi.org/10.3389/fmed.2018.00029
  22. Stepanova A.I., Kosogova A.Yu., Tegel’skii D.K., Geyushova Ya.N., Sorokoumova A.A. Dental status of HIV-infected patients in Tyumen city and Tyumen district. Problemy stomatologii. 2024; 20(2): 89–93. https://doi.org/10.18481/2077-7566-2024-20-2-89-93 https://elibrary.ru/mjvflj (in Russian)
  23. Rodríguez-Montaño R., Martínez-Nieto M., González-Alvarez G.E., Alarcón-Sánchez M.A., Becerra-Ruiz J.S., Heboyan A., et al. Hepatitis and periodontal health: an emerging oral-liver axis. Ther. Adv. Chronic Dis. 2025; 16: 20406223251368090. https://doi.org/10.1177/20406223251368090
  24. Bradley E.L.P., Vidot D.C., Gaul Z., Sutton M.Y., Pereyra M. Acceptability of oral rapid HIV testing at dental clinics in communities with high HIV prevalence in South Florida. PLoS One. 2018; 13(4): e0196323. https://doi.org/10.1371/journal.pone.0196323
  25. Nakyonyi M.G., Birungi N., Mwesigwa C.L., Åstrøm A.N. Use of dental care services among adolescents living with HIV on antiretroviral treatment in Kampala, Uganda: a cross-sectional study. BMC Oral Health. 2024; 24(1): 654. https://doi.org/10.1186/s12903-024-04426-z
  26. Al-Mendalawi M.D. Comment on: Prevalence of hepatitis B, C, and HIV among patients attending a teaching dental hospital. A 7-year retrospective study from the United Arab Emirates. Saudi Med. J. 2018; 39(9): 954–5. https://doi.org/10.15537/smj.2018.9.22985
  27. Pokrovskii V.V., Ladnaya N.N., Sokolova E.V., Buravtsova E.V. HIV infection. Informatsionnyi byulleten’ Rossiiskogo fonda fundamental’nykh issledovanii. 2008; (31): 3–24. https://elibrary.ru/qcwksl (in Russian)
  28. Anufrieva E.V., Serikova E.N., Ostankova Yu.V., Shchemelev A.N., Davydenko V.S., Reingardt D.E., et al. The structure of some blood-borne infections distribution among persons from penitentiary institutions the markers. VICH-infektsiya i immunosupressii. 2023; 15(3): 97–106. https://doi.org/10.22328/2077-9828-2023-15-3-95-104 https://elibrary.ru/lsmcfg (in Russian)
  29. Anufrieva E.V., Ostankova Yu.V., Serikova E.N., Shchemelev A.N., Davydenko V.S., Reingardt D.E., et al. Prevalence of serological and molecular-biological HIV-infection, HBV and HCV markers among medical workers. Problemy osobo opasnykh infektsii. 2024; (4): 54–62. https://elibrary.ru/ytxefi (in Russian)
  30. Ostankova Yu.V., Valutite D.E., Zueva E.B., Serikova E.N., Shchemelev A.N., Boumbaly S., et al. Primary HCV drug resistance mutations in patients with newly diagnosed HIV infection. Problemy osobo opasnykh infektsii. 2020; (3): 97–105. https://doi.org/10.21055/0370-1069-2020-3-97-105 https://elibrary.ru/laroef (in Russian)
  31. Khorkova E.V., Lyalina L.V., Mikailova O.M., Kovelenov A.Yu., Ostankova Yu.V., Valutite D.E., et al. Current issues of epidemiological surveillance of chronic viral hepatitis B, C, D and hepatocellular carcinoma at the regional level. Zdorov’e naseleniya i sreda obitaniya – ZNISO. 2021; 29(8): 76–84. https://doi.org/10.35627/2219-5238/2021-29-8-76-84 https://elibrary.ru/mhcuqj (in Russian)
  32. Palanisamy N., Kalaghatgi P., Akaberi D., Lundkvist Å., Chen Z.W., Hu P., et al. Worldwide prevalence of baseline resistance-associated polymorphisms and resistance mutations in HCV against current direct-acting antivirals. Antivir. Ther. 2018; 23(6): 485–93. https://doi.org/10.3851/IMP3237
  33. Akaberi D., Bergfors A., Kjellin M., Kameli N., Lidemalm L., Kolli B., et al. Baseline dasabuvir resistance in Hepatitis C virus from the genotypes 1, 2 and 3 and modeling of the NS5B-dasabuvir complex by the in silico approach. Infect. Ecol. Epidemiol. 2018; 8(1): 1528117. https://doi.org/10.1080/20008686.2018.1528117
  34. Pessoa L.S., Vidal L.L., Costa E.C., Abreu C.M., Cunha R.D., Valadão A.L., et al. Development of a rapid phenotypic test for HCV protease inhibitors with potential use in clinical decisions. Genet. Mol. Biol. 2016; 39(3): 358–64. https://doi.org/10.1590/1678-4685-GMB-2016-0022
  35. Reingardt D.E. Molecular-genetic characteristics of the hepatitis C virus in the context of direct-acting antiviral therapy: Diss. St. Petersburg; 2025. (in Russian)
  36. Ostankova Yu.V., Serikova E.N., Shirshova N.Yu., Kusevitskaya M.B., Gorskaya O.A., Basina V.V., et al. Prevalence of occult hepatitis b infection among blood donors in Saint Petersburg. Infektsiya i immunitet. 2023; 13(6): 1129–40. https://doi.org/10.15789/2220-7619-POO-14480 https://elibrary.ru/xhpybw (in Russian)
  37. Lazarevic I., Banko A., Miljanovic D., Cupic M. Immune-escape hepatitis B virus mutations associated with viral reactivation upon immunosuppression. Viruses. 2019; 11(9): 778. https://doi.org/10.3390/v11090778
  38. Rajput M.K. Mutations and methods of analysis of mutations in Hepatitis B virus. AIMS Microbiol. 2020; 6(4): 401–21. https://doi.org/10.3934/microbiol.2020024
  39. Piermatteo L., D’Anna S., Bertoli A., Bellocchi M., Carioti L., Fabeni L., et al. Unexpected rise in the circulation of complex HBV variants enriched of HBsAg vaccine-escape mutations in HBV genotype-D: potential impact on HBsAg detection/quantification and vaccination strategies. Emerg. Microbes Infect. 2023; 12(1): 2219347. https://doi.org/10.1080/22221751.2023.2219347
  40. Gencay M., Hübner K., Gohl P., Seffner A., Weizenegger M., Neofytos D., et al. Ultra-deep sequencing reveals high prevalence and broad structural diversity of hepatitis B surface antigen mutations in a global population. PLoS One. 2017; 12(5): e0172101. https://doi.org/10.1371/journal.pone.0172101
  41. Al-Qahtani A.A., Al-Anazi M.R., Nazir N., Abdo A.A., Sanai F.M., Al-Hamoudi W.K., et al. The correlation between hepatitis B virus precore/core mutations and the progression of severe liver disease. Front. Cell Infect. Microbiol. 2018; 8: 355. https://doi.org/10.3389/fcimb.2018.00355
  42. Kumar R. Review on hepatitis B virus precore/core promoter mutations and their correlation with genotypes and liver disease severity. World J. Hepatol. 2022; 14(4): 708–18. https://doi.org/10.4254/wjh.v14.i4.708
  43. Liu S., Zhang H., Gu C., Yin J., He Y., Xie J., et al. Associations between hepatitis B virus mutations and the risk of hepatocellular carcinoma: a meta-analysis. J. Natl. Cancer Inst. 2009; 101: 1066–82. https://doi.org/10.1093/jnci/djp180
  44. Yll M., Cortese M.F., Guerrero-Murillo M., Orriols G., Gregori J., Casillas R., et al. Conservation and variability of hepatitis B core at different chronic hepatitis stages. World J. Gastroenterol. 2020; 26(20): 2584–98. https://doi.org/10.3748/wjg.v26.i20.2584
  45. Reuter T., Gomes-Gouvea M.S., Chuffi S., Duque U.H., Perini W., Azevedo R.S., et al. Core promoter and pre-core variants of the hepatitis B virus (HBV) are frequent in chronic hepatitis B HBeAg-negative patients infected by genotypes A and D. Viruses. 2023; 15(12): 2339. https://doi.org/10.3390/v15122339
  46. Sanaei N., Hashemi S.M.A., Dehno S.Z.S., Asl M.M., Moini M., Malek-Hosseini S.A., et al. Precore/core mutations of hepatitis B virus genotype D arising in different states of infection. Clin. Exp. Hepatol. 2022; 8(1): 21–8. https://doi.org/10.5114/ceh.2022.114253

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2025 Ostankova Y.V., Serikova E.N., Schemelev A.N., Anufrieva E.V., Zueva E.B., Kreidik O.S., Kusevitskaya M.B., Kusevitskiy L.Y., Totolian A.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).