Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
The epidemiology of hepatitis C virus transmission.
Diss Abstr Int [B]; 53(10):5160 1993. Unique Identifier : AIDSLINE ICDB/94690954 Osmond DH; Univ. of California, Berkeley
Abstract:
Hepatitis C virus (HCV) is a newly identified virus that is the most important agent of non-A non-B hepatitis and is associated with cirrhosis and hepatocellular carcinoma. HCV is readily transmitted intravenously by blood and blood products, but preliminary reports have disagreed about the importance of perinatal and sexual transmission. In 170 heterosexual couples, 18% of the women (31/170) and 33% of the men (56/170) were HCV seropositive by RIBA-2 immunoblot. Intravenous drug use (IVDU) (OR = 27.0, 95% CI = 13.4-56.1, p less than 0.0001), hemophilia (OR = infinity, 95% CI = 1.9-infinity, p = 0.01), and history of blood transfusion (OR = 2.7, 95% CI = 1.1-7.0, p = 0.02) were significantly associated with HCV seropositivity. No associations were found for measures of sexual behavior within HCV concordant couples or with number of sexual partners, history of sexually transmitted diseases, or HIV seropositivity. However, 2/31 females without parenteral risk but with an HCV positive male partner were HCV seropositive compared with 0/81 females with an HCV negative partner (p = 0.07). Thirty-four (4.6%) of 735 homosexual/bisexual men were HCV seropositive by RIBA-2 immunoblot compared to 81% who were positive for one or more hepatitis B virus (HBV) serological markers. History of IVDU (OR = 14.3, 95% CI = 6.4-31.9, p less than 0.0001) and history of blood transfusion (OR = 4.7, 95% CI = 1.3-13.8, p = 0.009) were strongly associated with HCV seropositivity but neither was significantly associated with HBV seropositivity. Sexual behavior variables were associated with infection with both viruses. After controlling for IVDU and a history of blood transfusion, there were marginal associations of HCV with more than 50 sexual partners in a year (OR = 2.4, 95% CI = 1.1-5.4, p = 0.03) and with more than 25 anal receptive partners (OR = 2.2, 95% CI = 1.0-5.0, p = 0.05) and stronger associations of HBV with the same variables (OR = 2.8, CI = 1.5-5.4, p = 0.001 and OR = 3.2, CI = 1.5-6.6, p = 0.001, respectively). Together the two studies and a review of the HCV literature indicated that intravenous exposure to blood and blood products is the primary route of HCV transmission but that HCV is transmitted sexually, albeit infrequently. Because there is reason to believe that HCV infection tends to become chronic and that a high proportion of those positive for HCV antibodies may be infectious, the pool of asymptomatic HCV carriers may be large and sexual transmission may play a more significant role in spreading HCV than the relative inefficiency of its transmission would suggest. (Full text available from University Microfilms International, Ann Arbor, MI, as Order No. AAD93-05026)
Keywords: Female Hepatitis C/BLOOD/*EPIDEMIOLOGY/TRANSMISSION Homosexuality Human HIV Seropositivity Male Sex Behavior Sexual Partners Sexually Transmitted Diseases/TRANSMISSION THESIS
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
