Hepatitis C virus infection among sexually promiscuous groups and the heterosexual partners of hepatitis C virus infected index cases

Abstract

To define the role of sexual transmission in the spread of hepatitis C virus (HCV) infection, a seroprevalence study of antibodies against HCV was performed in populations at high risk for sexually transmitted diseases. Subjects included 310 female prostitutes, 88 clients of prostitutes, 168 homosexual men and 147 stable heterosexual partners of index cases reactive for anti-HCV (98 of whom were partners of drug addicts coinfected with HCV and human immunodeficiency virus [HIV]). All subjects denied prior transfusion or intravenous drug use. Controls were 400 voluntary blood donors selected randomly from first-time donors. The prevalence of anti-HCV by enzyme immunoassay, confirmed by a second-generation recombinant immunoblot assay, was 6.4% in prostitutes, 6.8% in clients of prostitutes, 4.2% in homosexual men, 7.4% in heterosexual partners of index cases and 1.2% in random donors. However, the anti-HCV prevalence in stable heterosexual partners of HCV-positive/HIV-positive index cases was 2.2 times higher than in stable heterosexual partners of index cases reactive for anti-HCV only (9.2% vs. 4.1%), and sexual partners of index cases coinfected with HCV and HIV were almost three times more likely to be infected with HIV than with HCV (25.5% vs. 9.2%). These data suggest that HCV infection may be sexually transmitted but with low efficiency and that this efficiency could be increased in the presence of coexistent HIV infection in the index case.

Importance of sexual transmission of hepatitis C virus in seropositive pregnant women: A case-control study

“…High anti-HCV seroprevalence rates have been found in non-drugusing heterosexual population attending STD clinics and in non-drug-using female prostitutes [Alter, 1995]. Conversely, many other studies addressed to compare the prevalence of anti-HCV in sexually promiscuous homosexual males [Osmond et al, 1983b; Domínguez [Thomas et al, 1994], prostitutes [Lissen et al, 1993;Wu et al, 1993], and sexual partners of patients with chronic hepatitis C [Everhart et al, 1990;Brackman et al, 1993;Oshita et al, 1993;Osmond et al, 1993a;Akahame et al, 1994] with that of blood donors of the same area either failed to demonstrate sexual transmission of hepatitis C or suggested that such transmission occurred at a very low level of efficiency, much lower than that of hepatitis B virus or human immunodeficiency virus. Several sources of bias in the latter studies, such as the use of a first-generation ELISA, which had a low sensitivity and specificity, and the inappropriate use of blood donors as a control group, were avoided in the present study.…”

“…Inapparent parenteral inoculations and sexual contacts with an infected person might explain the 50% of cases unrelated to blood transfusions and to drug misuse. Previous studies on the relative importance of sexual and household transmission of HCV and the role of medical procedures in transmission of infection gave equival results [Everhart et al, 1990;Eyster et al, 1991;Brackman et al, 1993;Lissen et al, 1993;Oshita et al, 1993;Osmond et al, 1993a;Osmond et al, 1993b;Wu et al, 1993;Chang et al, 1994;Thomas et al, 1994]. A better knowledge of the modes of HCV transmission is needed for the adoption of preventive measures by those at risk.…”

Hepatitis C virus seroprevalence and risk factors among patients with HIV infection

“…LISSEN et al 9 examined 147 such heterosexual partners, who denied intravenous drug use or blood transfusion. According to this study the anti-HCV prevalence in stable heterosexual partners of HCV/HIV index cases was 2.2 times higher than in stable heterosexual partners of index cases reactive for anti-HCV only (9.2% vs. 4.1%).…”

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

“…Beberapa studi melaporkan bahwa koinfeksi HIV/HCV dapat mempercepat progresivitas penyakit ke arah sirosis hati 4,5 dan meningkatkan mortalitas yang berhubungan dengan sirosis dekompensata dan karsinoma sel hati. 3,6,7 Lebih lanjut, beberapa studi juga mendapatkan bahwa koinfeksi HIV/HCV dapat meningkatkan risiko transmisi seksual virus hepatitis C. [8][9][10][11][12] Hepatitis C paling mudah ditularkan melalui rute parenteral seperti penggunaan narkotika suntik 13 dan transfusi darah 14 , akan tetapi sulit ditularkan melalui rute seksual. Masih terdapat pro kontra mengenai transmisi seksual virus hepatitis C. Beberapa studi mendapatkan bahwa risiko transmisi seksual hepatitis C memang ada, namun risiko tersebut rendah.…”

“…[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.…”