Sexual transmission of HCV among monogamous heterosexual couples: The HCV partners study.

University of California San Francisco, Division of Gastroenterology, 513 Parnassus Ave, S357, Box 0538, San Francisco, CA, 94143. .
Hepatology (Impact Factor: 11.06). 03/2013; 57(3). DOI: 10.1002/hep.26164
Source: PubMed


The efficiency of hepatitis C virus (HCV) transmission by sexual activity remains controversial. We conducted a cross-sectional study of HCV-positive subjects and their partners to estimate the risk for HCV infection among monogamous heterosexual couples. A total of 500 anti-HCV-positive, human immunodeficiency virus-negative index subjects and their long-term heterosexual partners were studied. Couples were interviewed separately for lifetime risk factors for HCV infection, within-couple sexual practices, and sharing of personal grooming items. Blood samples were tested for anti-HCV, HCV RNA, and HCV genotype and serotype. Sequencing and phylogenetic analysis determined the relatedness of virus isolates among genotype-concordant couples. The majority of HCV-positive index subjects were non-Hispanic white, with a median age of 49 years (range, 26-79 years) and median of 15 years (range, 2-52 years) of sexual activity with their partners. Overall, HCV prevalence among partners was 4% (n=20), and nine couples had concordant genotype/serotype. Viral isolates in three couples (0.6%) were highly related, consistent with transmission of virus within the couple. Based on 8,377 person-years of follow-up, the maximum incidence rate of HCV transmission by sex was 0.07% per year (95% confidence interval, 0.01-0.13) or approximately one per 190,000 sexual contacts. No specific sexual practices were related to HCV positivity among couples.

The results of this study provide quantifiable risk information for counseling long-term monogamous heterosexual couples in which one partner has chronic HCV infection. In addition to the extremely low estimated risk for HCV infection in sexual partners, the lack of association with specific sexual practices provides unambiguous and reassuring counseling messages.

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Available from: Miriam J Alter, Mar 24, 2014
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    • "Current understanding of the natural history of HCV is still far from comprehensive. Even though it has been shown that HCV is rarely sexually transmitted, compared to other parentally transmitted viruses, such as hepatitis B or HIV [4], the role of heterosexual intercourse in HCV infection acquisition remains controversial. "
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    ABSTRACT: Hepatitis C virus (HCV) infection is a significant global health issue because it is widespread and persistent and can cause serious liver diseases. The aim of this study is to estimate HCV prevalence in women from the general population in different geographical areas worldwide and to assess the potential role of sexual behaviour in the virus transmission. Each participating centre recruited a random sample of women from the general population aged from less than 20 to more than 75 years. The study included 8130 women from 8 countries with information on sociodemographic factors, reproductive and sexual behaviour, smoking habit and HPV DNA through individual interviews. A blood sample was also collected to perform serological tests. We estimated the prevalence ratios associated to HCV to evaluate the effect of sexual behaviour in viral transmission. Women were reactive to a minimum of two HCV antigens, including at least one non structural protein were considered as positive (33% of the samples were classified as positive, 40% as negative, and 27% as indeterminate (N=402), that were considered as not positive). The age-adjusted HCV seroprevalence varied significantly by regions (0.3% in Argentina to 21.1% in Nigeria). We found no association between HCV prevalence and age, educational level, smoking habit and any of the available variables for sexual behaviour and reproductive history. This large study showed heterogeneous distribution of HCV seroprevalence in female and provides evidence of the null impact of sexual behaviour in HCV transmission. Copyright © 2015 Elsevier B.V. All rights reserved.
    Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 05/2015; 68. DOI:10.1016/j.jcv.2015.05.005 · 3.02 Impact Factor
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    • "Like HIV and HBV, the basic sources of transmission for HCV are blood-borne. These include transmission via sexual practices (classifying it as a STI), but there are differences in the efficiency of transmission by heterosexual activity— " …an extremely infrequent event " [31] and " …an increased risk for sexual transmission of Hepatitis C among gay men who are HIV-positive " [32]. HCV also has a high risk potential owing to parenteral infection, e.g., injecting drug use [33]. "
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    • "A limitation of this review was that it did not describe a method to screen or classify studies in relation to sexual vs drug-related routes of exposure to HCV. Indeed, the inadvertent inclusion of HIV-positive MSM injectors may overestimate HCV seroconversion rates, because parenteral exposure is a much more efficient route of HCV transmission [29]. We believe that there have been no previous reviews synthesizing the risk of reinfection post-HCV treatment, which is highly relevant to the design of HCV control programs. "
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