학술논문

Sexual transmission of hepatitis C virus among monogamous heterosexual couples: the HCV partners study.
Document Type
article
Source
Hepatology (Baltimore, Md.). 57(3)
Subject
Humans
Hepacivirus
Hepatitis C
Chronic
Sexually Transmitted Diseases
Viral
Substance-Related Disorders
DNA
Viral
Incidence
Prevalence
Risk Factors
Risk-Taking
Sexual Behavior
Heterosexuality
Phylogeny
Genotype
Adult
Aged
Aged
80 and over
Middle Aged
Sexual Partners
California
Female
Male
Young Adult
Hepatitis C
Chronic
Sexually Transmitted Diseases
Viral
DNA
and over
Gastroenterology & Hepatology
Clinical Sciences
Medical Biochemistry and Metabolomics
Immunology
Language
Abstract
UnlabelledThe 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.ConclusionThe 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.