Risk factors for the transmission of hepatitis C
Author: Zeuzem S; Teuber G; Lee JH; Rüster B; Roth
Source: J Hepatol
Date of Pub: 1996 Issue: 2 Volume: 24 Pagination: 3-10
Due to the availability of testing for antibodies to the hepatitis
C virus (anti-HCV) and with the use of the polymerase chain
reaction (RT-PCR) to detect HCV-RNA, more sensitive and specific
measures can be applied to assess routes of HCV transmission. The
aim of the present study was to investigate possible risk factors
for transmission of HCV.
160 consecutive patients with chronic hepatitis C (mean age 47.1
+/- 14.1 yr) attending a hepatology out-patient clinic were
interviewed to identify transmission risk factors. Genotyping of
HCV isolates was performed by direct sequencing of RT-PCR products
in the 5'-noncoding and the NS-5 region.
The risk factors of HCV infection were as follows: transfusion of
blood or blood products 34.4%, intravenous drug abuse 20.6%,
heterosexual contact 3.8%, occupational risk 1.9% and tattoo 0.6%.
In 62/160 (38.7%) the route of transmission remained unknown. In
one HCV-infected couple we analyzed the nucleotide sequences of the
NS-5 region of the respective HCV isolates and found almost
complete sequence homology (> 97%). The majority of patients
with post-transfusional or unknown mode of transmission were
infected with genotype HCV-1a and -1b, while in 6/10 patients with
previous i.v. drug abuse, genotype HCV-3a was present. We found no
evidence that the mode of disease acquisition influences the course
of liver disease.
The majority of patients with chronic hepatitis C have a classical
parenteral transmission risk factor. In our study, no source of HCV
acquisition was identified in 38.7% of patients. It may well be
that the major factors in these "sporadic" HCV infections are
variations on the known risk factors. However, since the proportion
of these cases is rather high, further attention should be on
alternative and as yet unclear transmission routes.
Abstract By: Author
Address: Medical Department II, University Hospital, Frankfurt,
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