Absence of hepatitis C virus transmission in a prospective cohort of heterosexual serodiscordant couples

Abstract

Objective: To analyse hepatitis C virus (HCV) transmission in a cohort of heterosexual couples who are discordant both for HIV and for HCV. Methods:We followed an open cohort of 171 people, 152 women and 19 men, who were not initially infected by either HIV or HCV, and whose steady heterosexual partner presented antibodies to both viruses (index case). Other risk exposures were excluded. Every 6 months clinical, epidemiological, and risk behaviour information was collected, and antibodies to both viruses were determined. Results: During 529 person years of follow up more than 40 000 vaginal or anal penetrations were recorded. 74 partners (43.3%) had vaginal and/or anal intercourse without condoms with the index case; another 15.8%, who always used condoms, declared breaking or slipping episodes during intercourse; and another 22.2% had unprotected orogenital exposures. During the follow up, over 5800 unprotected vaginal and anal contacts with the index case were estimated, as well as more than 25 000 unprotected orogenital contacts. 31 women became pregnant (two were index cases), and seroconversion to HIV occurred for one woman (1.7 per 10 000 unprotected contacts; 95% CI, 0 to 9.5), but there was no seroconversion to HCV (95% CI, 0-6.3 per 10 000 unprotected contacts). Conclusion: These results are consistent with a low or null transmissibility of HCV in heterosexual relations, even when the index case is HIV co-infected.

Sexual transmission of hepatitis C

“…However, the majority of studies mention rates of between zero and 3%. These low indexes, associated with rare risk factors, suggest that sexual transmission presents a minimal or negligible risk 18,30,31,44,49,51,54,69,82,83,92 .…”

“…However, the majority of studies mention rates of between zero and 3%. These low indexes, associated with rare risk factors, suggest that sexual transmission presents a minimal or negligible risk 18,30,31,44,49,51,54,69,82,83,92 .Studies that discuss specific groups, such as those who attend clinics for sexually transmitted diseases like drug abusers, homosexuals and sex workers, reveal findings that differ from those of the general population, and the risks of sexual transmission of HCV increase considerably 12,15,18,23,25,26,37,51,61,65,68,69,83,85,91 . …”

“…However, coinfection by HIV may increase these values. MARINCOVICH et al (2003) 44 , on evaluating a cohort of 171 heterosexuals, initially seropositive for HCV and HIV, suggested that the sexual transmission of HCV is extremely low or even null, and no couple in the population studied converted seropositively for HCV 44,79,82 .…”

Limited evidence of HCV transmission in stable heterosexual couples from Bahia, Brazil

“…A historical series of risk factors identified for acute HCV hepatitis in the United States from 1986 to 1996 clearly show a marked drop of transfusions and an elevated curve of sexual exposure in the absence of other known risk factors [7]. Most studies focusing on stable heterosexual couples, however, found a 0-3% risk of transmission from an infected partner to the other [8][9][10][11][12]. Therefore, many authors argument that sexual contact brings a minimal or negligible risk of transmission.…”

HIV Co-Infection with Hepatotropic Viruses and Mycobacterial Tuberculosis

“…Percutaneous exposure of health care workers to blood from coinfected patients was also shown to increase the risk of acquiring HCV [40]. Sexual transmission of HCV is rare even to partners of co-infected patients [44].…”