Hepatitis C virus infection and assisted reproduction

Passos, E.P.; Silveira, Themis Reverbel da; Salazar, Cristiano Caetano; Facin, Andrea Cintra; Souza, Clarice; Guerin, Yherar Lavic Serrano; Gratão, Ana Angélica; Cunha-Filho, João Sabino

doi:10.1093/humrep/17.8.2085

Cited by 19 publications

(12 citation statements)

References 19 publications

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“…The authors concluded that sexual transmission plays an important role in the propagation of HCV infection in humans. PASSOS et al (2002) 62 concluded that sexual and perinatal transmission was low among 409 patients from an assisted reproduction clinic. In 1995, FIGUEIREDO et al 22 analyzed 83 couples, and the incidence of 2.4% in this group suggested sexual transmission.…”

Section: Souto Et Al (1994)mentioning

confidence: 99%

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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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Section: Souto Et Al (1994)mentioning

confidence: 99%

“…In 1995, FIGUEIREDO et al 22 analyzed 83 couples, and the incidence of 2.4% in this group suggested sexual transmission. The authors considered this route to be probable but not very efficient 22,50,62,88 .…”

Section: Souto Et Al (1994)mentioning

confidence: 99%

Sexual transmission of hepatitis C

Cavalheiro

2007

Rev. Inst. Med. trop. S. Paulo

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“…La transmisió n de la infecció n ocurre principalmente mediante la vía parenteral, aunque tambié n se puede dar por contacto sexual y transmisió n vertical. Si bien aú n no se ha calculado el riesgo exacto de una posible transmisió n vertical madre-hijo, se ha observado en mujeres con altos niveles de viremia la capacidad de infectar a su descendencia 34 y se ha reportado que mujeres co-infectadas con VHC y VIH-1 tienen un mayor incremento en las posibilidades de transmitir la hepatitis C a sus hijos 35 . Cerca de 150-180 millones de personas en el mundo son portadoras de la enfermedad y hasta el momento solamente se ha reportado una tasa del 5% de transmisió n de la infecció n por vía sexual y vertical 36 .…”

Section: Virus De La Hepatitis Cunclassified

“…Ante tanta polé mica, se ha concluido que el virus se encuentra presente en semen en bajas o en indetectables concentraciones, dependiendo de la metodología empleada para la detecció n, lo que no representaría un riesgo alto de transmisió n sexual, pero sí podría contribuir a la infertilidad masculina a causa de reacciones inmunoló gicas e inflamatorias 35 .…”

Section: Virus De La Hepatitis Cunclassified

Virus de transmisión sexual: relación semen y virus

2010

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“…The risk of hepatitis C transmission in assisted reproduction techniques is currently the subject of widespread debate 11,22,33 . LEVY et al investigated the presence of HCV RNA in the semen of infected men in order to find out if semen fractions act as a reservoir for the hepatitis C virus.…”

Section: Introductionmentioning

confidence: 99%

Detection of HIV and HCV RNA in semen from Brazilian coinfected men using multiplex PCR before and after semen washing

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et al. 2006

Rev. Inst. Med. trop. S. Paulo

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SUMMARYIntroduction. Prolonged survival of patients under HAART has resulted in new demands for assisted reproductive technologies. HIV serodiscordant couples wish to make use of assisted reproduction techniques in order to avoid viral transmission to the partner or to the newborn. It is therefore essential to test the effectiveness of techniques aimed at reducing HIV and HCV loads in infected semen using molecular biology tests.Methods. After seminal analysis, semen samples from 20 coinfected patients were submitted to cell fractioning and isolation of motile spermatozoa by density gradient centrifugation and swim-up. HIV and HCV RNA detection tests were performed with RNA obtained from sperm, seminal plasma and total semen.Results. In pre-washing semen, HIV RNA was detected in 100% of total semen samples, whereas HCV RNA was concomitantly amplified in only one specimen. Neither HIV nor HCV were detected either in the swim-up or in the post-washing semen fractions.Conclusions. Reduction of HIV and/or HCV shedding in semen by density gradient centrifugation followed by swim-up is an efficient method. These findings lead us to believe that, although semen is rarely found to contain HCV, semen processing is highly beneficial for HIV/HCV coinfected individuals.

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Hepatitis C virus infection and assisted reproduction

Abstract: Since the risk for vertical and laboratory HCV infection is not well determined, and HCV prevalence is not negligible in this group, we recommend that infertile patients be screened before assisted reproductive techniques.

Cited by 19 publications

References 19 publications

Sexual transmission of hepatitis C

Sexual transmission of hepatitis C

Virus de transmisión sexual: relación semen y virus

Detection of HIV and HCV RNA in semen from Brazilian coinfected men using multiplex PCR before and after semen washing

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