N CaporasoØ{1}, T StroffoliniØ{2}, F Mennitti IppolitoØ{2}, A AscioneØ{3}, I FalzaranoØ{1}, G Del Vecchio BlancoØ{1}, C TuccilloØ{1}, F MoriscoØ{1}. Department of Internal Medicine, II University of NaplesØ{1}, Laboratory of Epidemiology, ISS RomeØ{2}, Division of Pathofisiology, "A Cardarelli" Hospital, NaplesØ{3}

It is not well known if familial environment plays some role in community-acquired HCV infection.

To verify modes of intrafamilial transmission of HCV.

Patients and Methods:
In a multicentre study, a cohort of 1509 household contacts (455 spouses, 924 other family members, 130 non-tested) of 585 anti-HCV and HCV-RNA positive patients, affected by histologically proven chronic hepatitis, were enrolled. HCV-antibodies were tested by ELISA III (Ortho Diagnostic System) and HCV-RNA by RT-PCR in all positive family members.

The prevalence of anti-HCV positivity in spouses is higher than in other relatives; 15.6% (71/455) vs. 3.2% (30/924) (p<0.01). The prevalence of anti-HCV positivity resulted higher in spouses with more than 20 years of marriage than in those with less; 19.8% and 8.0% respectively (O.R. 2.8; C.I. 95% 1.5-5.3). At the multivariate analysis, the condition of spouse of an HCV positive carrier is independently associated from other variables (any parenteral exposure and age) to the likelihood of being HCV positive (Table).

     VARIABLES                        O.R.    C.I.95%
     Any parenteral exposure          4.3     1.7-11.0
     Spouse vs other relationship     2.0     1.2-3.4
     Age>45 vs <45                    3.7     2.2-6.5

Spouses have a 2-fold risk to be HCV infected compared to other relatives. Sexual transmission may play some role in the intrafamily spread of HCV infection. Even if the risk is low, spouses of HCV positive carriers should be counselled about this mode of HCV transmission.

Source: American Association for the Study of Liver Diseases - 1996 Annual Meeting

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