Study Offers Evidence for Sexual Transmission of HCV


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Transmission (HCV)-Study Offers Evidence for Sexual Transmission ( Contemporary Women's Issues Database ); Transmission (HCV)-Study Offers Evidence for Sexual Transmission Hepatitis Weekly, 05-18-1998

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 Emirates.

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 Emirates.

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 (control group).

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 Emirates.

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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