Covert transmission of hepatitis C virus during bloody fisticuffs

Bourlière, Marc; Halfon, Philippe; Quentin, Yves; Parra, David; Mengotti, Cecile; Portal, Isabelle; Khiri, H.; Benali, Souâd; Perrier, H.; Boustière, Christian; Jullien, Monique; Lambot, G.

doi:10.1053/gast.2000.9303

Cited by 22 publications

(10 citation statements)

References 19 publications

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“…The risk for inmates to be HCV positive has been associated with injection drug use, tattooing and previous incarceration [20-26]. In addition, the possibility of person-to-person HCV transmission through exposure to contaminated blood cannot be dismissed [27]. …”

Section: Discussionmentioning

confidence: 99%

Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control study

Brandão

Fuchs

2002

BMC Gastroenterol

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BackgroundIn Brazil, it is estimated that between 2.5 and 4.9% of the general population present anti-hepatitis C virus (HCV) antibodies, which corresponds to as many as 3.9 to 7.6 million chronic carriers. Chronic liver disease is associated with HCV infection in 20% to 58% of the Brazilian patients. The objective of this case-control study was to investigate the risk factors for presence of anti-HCV antibody in blood donors in southern Brazil.MethodsOne hundred and seventy eight blood donors with two positive ELISA results for anti-HCV were cases, and 356 controls tested negative. A standardized questionnaire was used to collect data concerning demographic and socioeconomic aspects, history of previous hepatitis infection, social and sexual behaviors, and number of donations. Variables were grouped into sets of hierarchical categories. Cases and controls were compared using logistic regression, odds ratios, and 95% confidence intervals. The statistical significance of the associations was assessed through likelihood ratio tests based on a P value < 0.05.ResultsThe prevalence of anti-HCV among blood donors was 1.1%. Most of the donors were white and males. In the multivariate analysis, independent predictors of anti-HCV positivity were: intravenous drug use, blood transfusion >10 years earlier, having had two to four sexually transmitted diseases, incarceration, tattooing, sex with a hepatitis B or C virus carrier or with intravenous drug users.ConclusionIntravenous drug use, blood transfusion, and tattooing were the main risk factors for anti-HCV positivity among blood donors from southern Brazil, but sexual HCV transmission should also be considered.

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Section: Discussionmentioning

confidence: 99%

Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control study

Brandão

Fuchs

2002

BMC Gastroenterol

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“…We also sought to investigate the possibility that HCV transmission between sexual partners might take place via exposure to bleeding caused by intimate partner violence, rather than or in addition to unsafe sexual practices. This mechanism was suggested by a case report of HCV transmitted via a bloody fist fight18 and research indicating that risky sexual behavior (e.g., having multiple sexual partners) is positively associated with intimate partner violence 19–21…”

mentioning

confidence: 98%

Risky Sexual Behavior, Bleeding Caused by Intimate Partner Violence, and Hepatitis C Virus Infection in Patients of a Sexually Transmitted Disease Clinic

Russell

Chen²,

Nochajski³

et al. 2009

Am J Public Health

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Objectives We sought to investigate independent contributions of risky sexual behaviors and bleeding caused by intimate partner violence to prediction of HCV infection. Methods We conducted a case–control study of risk factors among patients of a sexually transmitted disease clinic with and without HCV antibodies, group-matched by age. Results Multivariate analyses indicated that Black race (odds ratio [OR]=2.4; 95% confidence interval [CI]=1.3, 4.4), injection drug use (OR=20.3; 95% CI=10.8, 37.8), sharing straws to snort drugs (OR=1.8; 95% CI=1.01, 3.0), sharing razors (OR=7.8; 95% CI=2.0, 31.0), and exposure to bleeding caused by intimate partner violence (OR=5.5; 95% CI=1.4, 22.8) contributed significantly to the prediction of HCV infection; risky sexual behavior and exposure to blood or sores during sexual intercourse did not. Conclusions HCV risk among patients of a sexually transmitted disease clinic can be explained by direct blood exposure, primarily through injection drug use. Exposure to bleeding caused by intimate partner violence may be a previously unrecognized mechanism for HCV transmission associated with risky sexual behavior.

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“…Nonetheless, the nosocomial transmission of HCV continues to occur (21). Several recent studies provided evidence of patient-to-patient transmission in most of the cases of nosocomial transmission (2, 5, 6, 9, 13, 15-17, 19, 20, 29, 36), although some studies also reported transmission from health care workers to patients and vice versa (10,26,32).In recent years, the use of molecular biology techniques has proven to be a powerful tool in the epidemiological investigation of HCV infection in health care facilities and other settings (2,4,6,9,10,13,15,16,19,20,24,30,32). In particular, phylogenetic tree analysis has often been used to identify the original source of infection.…”

mentioning

confidence: 99%

“…In recent years, the use of molecular biology techniques has proven to be a powerful tool in the epidemiological investigation of HCV infection in health care facilities and other settings (2,4,6,9,10,13,15,16,19,20,24,30,32). In particular, phylogenetic tree analysis has often been used to identify the original source of infection.…”

mentioning

confidence: 99%

Use of the Minimum Spanning Tree Model for Molecular Epidemiological Investigation of a Nosocomial Outbreak of Hepatitis C Virus Infection

et al. 2004

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The minimum spanning tree (MST) model was applied to identify the history of transmission of hepatitis C virus (HCV) infection in an outbreak involving five children attending a pediatric oncology-hematology outpatient ward between 1992 and 2000. We collected blood samples from all children attending since 1992, all household contacts, and one health care worker positive for antibody to HCV (anti-HCV). HCV RNA detection was performed with these samples and with smears of routinely collected bone marrow samples. For all isolates, we performed sequence analysis and phylogenetic tree analysis of hypervariable region 1 of the E2 gene. The MST model was applied to clinical-epidemiological and molecular data. No additional cases were detected. All children, but not the health care worker, showed genotype 3a. On six occasions, all but one child had shared the medication room with another patient who later seroconverted. HCV RNA detection in bone marrow smears revealed, in some cases, a delay of several months in anti-HCV responses. Sequence analysis and phylogenetic tree analysis revealed a high identity among the isolates. The MST model applied to molecular data, together with the clinical-epidemiological data, allowed us to identify the source of the outbreak and the most probable patient-to-patient chain of transmission. The management of central venous catheters was suspected to be the probable route of transmission. In conclusion, the MST model, supported by an exhaustive clinical-epidemiological investigation, appears to be a useful tool in tracing the history of transmission in outbreaks of HCV infection.Since the introduction of blood donor screening through antibody testing, the risk of acquiring infection with hepatitis C virus (HCV) through the transfusion of blood or blood products has dramatically decreased in industrialized countries (8,28,34). Nonetheless, the nosocomial transmission of HCV continues to occur (21). Several recent studies provided evidence of patient-to-patient transmission in most of the cases of nosocomial transmission (2, 5, 6, 9, 13, 15-17, 19, 20, 29, 36), although some studies also reported transmission from health care workers to patients and vice versa (10,26,32).In recent years, the use of molecular biology techniques has proven to be a powerful tool in the epidemiological investigation of HCV infection in health care facilities and other settings (2,4,6,9,10,13,15,16,19,20,24,30,32). In particular, phylogenetic tree analysis has often been used to identify the original source of infection. However, this technique does not allow a detailed history of transmission to be traced or the modes of transmission to be identified, except in cases of provider-to-patient transmission.In an attempt to more completely describe nosocomial outbreaks of HCV infection, we adopted a parsimonious theoretical approach, referred to as the minimum spanning tree (MST) model (see Appendix). The MST approach, a concept of the graph theory, represents one of the most common problems of combinatorial optim...

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Covert transmission of hepatitis C virus during bloody fisticuffs

Cited by 22 publications

References 19 publications

Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control study

Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control study

Risky Sexual Behavior, Bleeding Caused by Intimate Partner Violence, and Hepatitis C Virus Infection in Patients of a Sexually Transmitted Disease Clinic

Use of the Minimum Spanning Tree Model for Molecular Epidemiological Investigation of a Nosocomial Outbreak of Hepatitis C Virus Infection

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