Transmission (HCV)-Study Offers Evidence for Sexual
Transmission ( Contemporary Women's Issues Database ); Transmission
(HCV)-Study Offers Evidence for Sexual Transmission Hepatitis
Sex may have a larger role in the spread of hepatitis C virus
than is widely believed, according to a report from the United Arab
The study found that interspousal transmission of hepatitis C
virus is not uncommon and suggests this is an important route of
intrafamilial hepatitis C spread.
Researcher Rachana M. Kumar and colleagues stopped short,
however, of concluding that the interspousal spread was due to
sexual transmission. The role of sexual contact in transmitting HCV
is controversial and remains to be established.
"Although sexual contact may be the most important route in
interspousal transmission, other routes of infection, such as
sharing of toothbrushes or contaminated razor blades could also be
involved although such routes were denied by our subjects," Kumar
et al. wrote ("Interspousal and Intrafamilial Transmission of
Hepatitis C Virus: A Myth or a Concern?" Obstetrics and Gynecology,
March 1998;91 (3):426-431).
It has long been believed that the risk of HCV transmission
between husband and wife was low. In 1992, however, Kao et al.
reported that interspousal transmission may be an important route
of intrafamilial HCV spread (J Infect Dis 1992;166:900-903).
In this study, Kumar et al. examined the incidence of
anti-hepatitis C virus antibodies in 224 family members of 65 index
patients with HCV. Sixty-five of the 94 index patients were
asymptomatic, apparently healthy parturient Egyptian women, who
were detected to be anti-hepatitis C virus positive at routine
antenatal screening and whose spouses resided in the United Arab
The serologic status of family members of seropositive index
patients was compared with that of 218 family contacts of 65
matched healthy anti-HCV negative parturient Egyptian women
To determine interspousal transmission, hepatitis C virus
genotype was determined in 35 of 36 HCV RNA positive index
patient-spouse pairs and 22 of 25 non-related RNA positive pairs by
polymerase chain reaction. Subsequently, nucleotide sequencing of
the hepatitis C virus genome was conducted.
In comparison with the control group, a significantly greater
number of family members of the index patients were anti-HCV
positive (five of 218 versus 60 of 224; p less than .004).
Husbands of index patients had the highest prevalence of
anti-HCV (74 percent), with longer duration of marriage being an
important risk factor. Of the 35 index patient-spouse pairs
analyzed, 33 (94 percent) had the same hepatitis C virus genotype.
On nucleotide sequencing, 30 couples showed 100 percent homology,
and two had a high (greater than 97 percent) homology.
Among nonspouse pairs, six pairs (27 percent) had the same
hepatitis C virus genotype; however, low nucleotide sequence
homologies (mess than 88 percent) were noted.
These data suggest that interspousal transmission of hepatitis C
virus occurs and that this may be an important route of
intrafamilial spread of hepatitis C virus infection.
"Clear delineation of the risk attributable solely to close
family contact is hindered in many studies by potential
transmission of hepatitis C virus by other routes, such as needle
sharing, sexual transmission between spouses, or by perinatal
transmission," Kumar et al. wrote.
"When sexual partners are distinguished from other family
members, rates of infection are consistently different. Sexual
partners had prevalences of Hembers in Taiwan (Carton et al., Md J
Austr 1997;6:333- 334) and 27 percent compared with 1.9 percent of
children in Italy (Van der Poel, Lancet 1994;344:1475-1479). This
study is in agreement. We detected a significantly higher
prevalence of HCV antibodies in spouses than in children."
The corresponding author for this study is Rachana M. Kumar,
United Arab Emirates University, Al-Ain, United Arab
Copyright 1998 Charles W. Henderson; Transmission (HCV)-Study
Offers Evidence for Sexual Transmission., Contemporary Women's
Issues Database, 05-18-1998, pp N/A.
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