Virus Load and Risk of Heterosexual Transmission of Human Immunodeficiency Virus and Hepatitis C Virus by Men with Hemophilia

Hisada, Michie; O’Brien, Thomas R.; Rosenberg, Philip S.; Goedert, James J.

doi:10.1086/315396

Cited by 64 publications

(35 citation statements)

References 12 publications

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“…Seroprevalence rates varied from 2.0% to 4.8%. [20][21][22] Preliminary data from the HCV Partners Study, a cross-sectional study of heterosexual monogamous couples, provides the best available estimate of risk among U.S. couples. In this study, which excludes couples in which injection drug use is present in both partners, the prevalence of anti-HCV among 401 partners was 4.2%, with genotype concordance present in 2.7% of couples (Terrault N, unpublished data).…”

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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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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“…Hasil ini mendukung hipotesis yang menyatakan bahwa rendahnya hitung CD4 + dapat berperan sebagai petanda untuk derajat viremia yang lebih tinggi atau lamanya kadar viremia pada pasien koinfeksi. 40 Penggunaan kondom yang tidak teratur secara teori dihubungkan dengan meningkatnya transmisi seksual virus hepatitis C. Penelitian ini mendapatkan tidak ada hubungan yang bermakna antara penggunaan kondom dengan kejadian hepatitis C meskipun terdapat peningkatan kejadian hepatitis C 3 kali lebih tinggi pada subyek dengan riwayat penggunaan kondom yang tidak teratur. Namun, berbagai studi sebelumnya melaporkan hasil yang tidak konsisten.…”

Section: Pembahasanunclassified

“…[8][9][10][11][12]18,37,40 Tipe hubungan seksual hanya dilaporkan pada studi atau laporan kasus hepatitis C pada populasi homoseksual atau studi kohort. Pada uji hipotesis didapatkan hubungan antara tipe hubungan seksual nonvaginal dan kejadian hepatitis C dengan risiko kejadian 5-6 kali lebih tinggi pada subyek dengan faktor risiko tersebut.…”

Section: Pembahasanunclassified

Faktor - Faktor yang Berhubungan dengan Kejadian Hepatitis C pada Pasangan Seksual Pasien Koinfeksi Human Immunodeficiency Virus dan Virus Hepatitis C

Kurniawati¹,

Karjadi²,

Gani³

2017

JPDI

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Pendahuluan. Pencegahan transmisi hepatitis C pada pasangan seksual pasien koinfeksi HIV/HCV merupakan upaya penatalaksanaan hepatitis C. Namun demikian, belum ada data prevalensi hepatitis C dan faktor yang berhubungan dengan transmisi hepatitis C pada pasangan seksual pasien koinfeksi HIV/HCV di Indonesia, sehingga perlu dilakukan penelitian untuk memperoleh data tersebut. Penelitian ini bertujuan untuk mengetahui prevalensi hepatitis C dan faktor-faktor yang berhubungan dengan kejadian hepatitis C pada pasangan seksual pasien koinfeksi HIV/HCV.Metode. Studi potong lintang pada pasangan heteroseksual pasien koinfeksi HIV/HCV yang berobat di Pokdisus RSCM. Faktor yang diteliti meliputi penggunaan narkotika suntik, transfusi darah, status HIV, penggunaan kondom, jumlah hubungan seksual, jumlah pasangan seksual, tipe hubungan seksual dan hitung CD4+ pasien koinfeksi HIV/HCV. Pengambilan data dilakukan dengan wawancara secara terpisah dan pemeriksaan darah antiHCV total dan antiHIV. Analisis statistik dilakukan dengan uji chi-square dan Fisher dan regresi logistik menggunakan program SPSS.Hasil. Selama periode Mei-Agustus 2008, diperoleh 119 subyek penelitian pada rentang usia 19-39 tahun (median 26 tahun) dan 95,8% diantaranya berjenis kelamin perempuan. Didapatkan prevalensi hepatitis C sebesar 10,1%. Hasil analisis bivariat kelompok subyek nonpengguna narkotika suntik didapatkan status HIV reaktif dan hubungan seksual nonvaginal berhubungan dengan kejadian hepatitis C. Pada hasil analisis multivariat didapatkan hanya tipe hubungan nonvaginal yang berhubungan dengan kejadian hepatitis C (adjusted RP 8,051; IK95% 1,215-53,353).Simpulan. Prevalensi hepatitis C pada pasangan seksual pasien koinfeksi HIV/HCV sebesar 10,1%. Tipe hubungan nonvaginal dan status antiHIV positif dapat meningkatkan risiko terjadinya kejadian hepatitis C sebesar 8 kali. Dibutuhkan studi lanjutan dengan sampel yang lebih besar dan desain yang lebih baik untuk menentukan transmisi seksual hepatitis C.

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“…Third, intervention with HAART during the period of primary infection may significantly alter disease course and the spread of infection (34)(35)(36)(37). Finally, given that viral load appears to be related to transmission (38)(39)(40)(41), initiating therapy is likely to reduce transmission of the virus across various stages of illness because viral loads will be lower.…”

Section: Shifting Context Of Hiv Testingmentioning

confidence: 99%

“…Although linking seropositive persons to care is an important goal in itself, increasing the proportion of infected individuals who are referred to and followup in care will also help to decrease rates of HIV transmission. Viral load is often decreased among persons who are linked to care and adhere to their treatment regimens (36,(77)(78)(79); lower viral load is associated with decreased rates of HIV transmission (38)(39)(40)(41).…”

Section: Shifting Context Of Hiv Testingmentioning

confidence: 99%

Effective Detection of HIV

Newman

Etzel

2000

Journal of Acquired Immune Deficiency Syndromes

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Summary: Biomedical advances, new HIV testing technologies, and policy shifts in the last 15 years have created substantial new challenges and opportunities for service providers, policy makers, and researchers regarding broad scale identification of HIVseropositive persons. Effective HIV testing will be achieved when we: (1) increase the number of high-risk persons tested; (2) decrease the time from HIV infection to detection; (3) increase testing acceptability; (4) increase the proportion of individuals tested who receive their results; and (5) increase the proportion of individuals tested seropositive who are linked to care. Strategies to enhance effectiveness include implementing new testing technologies and delivery modalities; expanding access to clientcontrolled testing; targeting providers' knowledge, attitudes, and behaviors regarding HIV testing; mainstreaming HIV testing as routine clinical care; targeting persons who engage in high-risk behaviors and those in high-risk groups; and implementing a national behavioral surveillance system. Addressing these challenges will improve HIV detection in the United States, which is vital to both HIV prevention and treatment.

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Virus Load and Risk of Heterosexual Transmission of Human Immunodeficiency Virus and Hepatitis C Virus by Men with Hemophilia

Cited by 64 publications

References 12 publications

Sexual activity as a risk factor for hepatitis C

Sexual activity as a risk factor for hepatitis C

Faktor - Faktor yang Berhubungan dengan Kejadian Hepatitis C pada Pasangan Seksual Pasien Koinfeksi Human Immunodeficiency Virus dan Virus Hepatitis C

Effective Detection of HIV

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