Hepatitis C virus infection in spouses: sexual transmission or common exposure to the same risk factors?

Stroffolini, Tommaso; Lorenzoni, U.; Menniti‐Ippolito, Francesca; Infantolino, D.; Chiaramonte, M.

doi:10.1111/j.1572-0241.2001.05267.x

Cited by 64 publications

(30 citation statements)

References 24 publications

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“…Another possible form of transmission is contact with perforating/cutting objects, such as nail clippers and beard razors, in either professional (e.g., beauty salons and barber shops) [19][20][21] or domiciliary environments 22,23 .…”

Section: Discussionmentioning

confidence: 99%

Risk factors for hepatitis C virus transmission in the municipality of Catanduva, State of São Paulo: a case-control study

Rosa

Martinelli

Passos

2014

Rev. Soc. Bras. Med. Trop.

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Introduction: Hepatitis C virus (HCV) is primarily transmitted via contact with the blood of infected patients, although the form of contact has not been identifi ed for a signifi cant percentage of carriers. The present study evaluated possible risk factors for HCV transmission in a medium-sized town located in the northwest region of the State of São Paulo. Methods: This was a case-control study, with the case group consisting of 190 chronic HCV carriers older than 18 years residing in the municipality of Catanduva. The control group also consisted of 190 individuals with HCV-negative serology. The groups were paired (1:1) for gender, age range (± fi ve years), and place of residence. The same structured questionnaire was applied to all subjects, who gave written informed consent to participate in the study. The data were statistically analyzed using crude and adjusted logistic regression, and the results were expressed as odds ratios with a 95% confi dence interval. Results: The demographic profi les of the groups indicated a predominance of males (68.9%) and mean ages of 47.1 years (case group) and 47.3 years (control group). After adjusting for conditional regression, the following factors were found to represent risks for HCV: history of sexually transmitted disease (STD) and blood transfusion; accidents with syringes and/or needles; tattoos; and the use of non-injectable drugs and injectable medications. Conclusions: The transmission of HCV via the blood route has been well characterized. Other forms of contact with human blood and/or secretions are likely to transmit the virus, although with a lower frequency of occurrence.

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Section: Discussionmentioning

confidence: 99%

Risk factors for hepatitis C virus transmission in the municipality of Catanduva, State of São Paulo: a case-control study

Rosa

Martinelli

Passos

2014

Rev. Soc. Bras. Med. Trop.

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“…The factors most consistently associated with HCV positivity among heterosexual partners were the presence of percutaneous risk factors for HCV (injection drug use, blood transfusion, sharing glass syringes). 11,[14][15][16] Early studies found the rate of HCV positivity in partners increased with the longer duration of marriage, suggesting risk of sexual transmission correlated with frequency of contact. 17 However, subsequent studies adjusting for age did not find a consistent relationship between the duration of the sexual relationship and HCV positivity in partners.…”

Section: What Is the Prevalence Of Hcv Infection In Monogamous Heteromentioning

confidence: 99%

Sexual activity as a risk factor for hepatitis C

Terrault

2002

Hepatology

134

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The accumulated evidence indicates that hepatitis C virus (HCV) can be transmitted by sexual contact but much less efficiently than other sexually transmitted viruses, including hepatitis B virus and human immunodeficiency virus (HIV). However, because sex is such a common behavior and the reservoir of HCV-infected individuals is sizable, sexual transmission of HCV likely contributes to the total burden of infection in the United States. Risk of HCV transmission by sexual contact differs by the type of sexual relationship. Persons in long-term monogamous partnerships are at lower risk of HCV acquisition (0% to 0.6% per year) than persons with multiple partners or those at risk for sexually transmitted diseases (0.4% to 1.8% per year). This difference may reflect differences in sexual risk behaviors or differences in rates of exposure to nonsexual sources of HCV, such as injection drug use or shared razors and toothbrushes. In seroprevalence studies in monogamous, heterosexual partners of HCV-infected, HIV-negative persons, the frequency of antibody-positive and genotype-concordant couples is 2.8% to 11% in Southeast Asia, 0% to 6.3% in Northern Europe, and 2.7% in the United States. Among individuals at risk for sexually transmitted diseases ( P ercutaneous exposures, such as blood transfusion and injection drug use, are well-established risk factors for hepatitis C virus (HCV) infection. The risk of HCV transmission by sexual contact, however, is less well defined. The accumulated epidemiologic evidence indicates that HCV can be transmitted by sexual contact but much less efficiently than other sexuallytransmitted viruses, including hepatitis B virus and human immunodeficiency virus (HIV).There are several case reports of acute hepatitis C occurring in persons whose only risk factor appeared to be a HCV-infected sexual partner. 1,2 The strength of these reports lay in their ability to document seroconversion in an individual at risk in temporal relationship to sexual activity with an HCV-infected partner. The mode of transmission was ascertained by carefully questioning the infected individual to exclude nonsexual sources of HCV. A high degree of sequence homology between the viral strains in the sexual partners provided virological confirmation that a transmission event had occurred.While there is sufficient evidence to support the conclusion that sexual transmission of HCV occurs, quantifying the magnitude of an individual's risk of HCV acquisition by sexual contact is more difficult. Epidemiologic studies have had several methodological shortcomings that tend to overestimate the proportion of HCV infections attributed to sexual contact. Early studies used first-generation antibody to HCV (anti-HCV) assays which have a higher false positive rate than second-and third-generation assays. Studies varied in the completeness of risk ascertainment in partners, and many failed to carefully exclude HCV acquisition from nonsexual sources (Fig. 1). Nondisclosure of injection drug use is particularly important because a...

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“…In mates of patients with chronic liver disease, five in 31 (16.12%) were positive, and in mates of patients with anti-HCV two in 42 (4.7%) were positive 75 . STROFFOLINI et al (2001) 81 concluded that despite eight of 13 couples presenting the same viral type, sexual transmission was considered low, and the sharing of syringes appeared to be the most effective route for virus transmission in couples 81 .…”

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confidence: 99%

Sexual transmission of hepatitis C

Cavalheiro

2007

Rev. Inst. Med. trop. S. Paulo

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SUMMARYIt is generally agreed that the hepatitis C virus (HCV) can be efficiently transmitted parenterally, although data on viral transmission by sexual or non-sexual intrafamilial contact are conflicting. Since data collection began in 1989, the first study dealt with the risk of sexual transmission among multiple sex partners. Other investigations followed, emphasizing that risk increases in specific groups such as patients co-infected with HIV and HBV, sex workers, homosexuals, illicit drug users and patients attended at sexually transmittable disease clinics.The question arises as to what might be the risk for monogamous heterosexuals in the general population, in which one of the partners has HCV?The literature provides overall rates that vary from zero to 27%; however, most studies affirm that the chances of sexual transmission are low or almost null, with rates for this mode fluctuating from zero to 3%. Intrafamilial transmission is strongly considered but inconclusive, since when mentioning transmission between sex partners within the same household, specific situations also should be considered, such as the sharing of personal hygiene items, like razorblades, toothbrushes, nail clippers and manicure pliers, which are important risk factors in HCV transmission. In this review, we discuss the hypotheses of sexual and/or intrafamilial transmission.KEYWORDS: Hepatitis C; Transmission; Sexual; Intrafamilial.Patients infected by HCV frequently question whether their infection can be transmitted to their sexual partners, and whether HCV can be transmitted through sexual relations. Common sense suggests that HCV like HBV and HIV can be transmitted through sexual contact, but what is the degree of risk? Does it depend on the population studied? Can risk behavior alter contamination potential 27,34,74 ?Classically, parenteral exposition unites many risk factors that are relevant for HCV transmission, such as the use of illegal drugs, hemodialysis, blood transfusion and blood derivatives, tattoos, organ transplants, acupuncture, sharing of straws for drug inhalation, and accidents in health-care workers 12,26,49,58,71,89 .Convincing evidence for the sexual transmission of HCV requires a history of couples having lived together in sexual activity, the absence of other opportunities for infection, and genetic evidence on the virus, demonstrating that both partners are infected by a virus with very similar genomic sequences. The possession of quality information concerning these questions can aid in providing answers to these issues. However, few studies meet these criteria satisfactorily 22,69,85 . ALTER et al. (1989) 2 presented the first study in which the possibility of HCV transmission was discussed, and considered multiple sex partners as a risk factor. However, the contribution of sexually transmitted HCV remains controversial. In the United States, the Centers for Disease control and Prevention (CDC) estimates that between 20 to 25% of the transmission indexes are associated with sexual contact, although ...

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Hepatitis C virus infection in spouses: sexual transmission or common exposure to the same risk factors?

Cited by 64 publications

References 24 publications

Risk factors for hepatitis C virus transmission in the municipality of Catanduva, State of São Paulo: a case-control study

Risk factors for hepatitis C virus transmission in the municipality of Catanduva, State of São Paulo: a case-control study

Sexual activity as a risk factor for hepatitis C

Sexual transmission of hepatitis C

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