Intrafamilial transmission of hepatitis C virus: The important role of inapparent transmission

Abstract

To evaluate the intrafamilial transmission of hepatitis C virus (HCV) 104 index patients with type C chronic liver disease and their 307 family contacts were interviewed. After a questionnaire on the risk factors of parenteral exposure, blood samples were obtained and tested for liver biochemistry and anti-HCV antibody by enzyme-linked immunosorbent assay (Abbott II). Overall, 52 family contacts (17%) were positive for anti-HCV, indicating a higher anti-HCV prevalence among family contacts than among the general population in Taiwan. The anti-HCV prevalences in parents, spouses, children, and other contacts of the patients were 54% (14/26), 28% (25/91), 6.9% (10/143), and 6.4% (3/47), respectively. The contacts of index patients had increasingly greater risk of HCV infection when they became older and had lived longer with index patients. All family contacts were divided into two groups categorized by whether the index patients had or did not have a history of parenteral exposure. Among 126 family contacts of the 42 patients without parenteral exposure, blood transfusion and surgery were the factors significantly associated with HCV infection in these family contacts (odds ratio = 7.26, 95% confidence interval = 2.32-32.67; odds ratio = 3.95, 95% CI = 1.29-12.11, respectively). Risk factors were not significantly associated with HCV infection among 181 family contacts of the 62 index patients with parenteral exposure. It is concluded that the index patients without parenteral exposure appeared to have acquired the disease from HCV-infected family members with risk factors. Most of the index patients had a history of parenteral exposure and in turn served as the source of the disease for family members.

Sexual transmission of hepatitis C virus

“…Logistic regression analysis showed an adjusted odds ratio of 1.5 for each decade of marriage (CI, 1.05-2.2). Similar infection rates were found in Taiwan studies 4,16 . However, sexual transmission is difficult to prove since other routes of infection currently being discussed may be present between the members of a couple, such as the shared use of utensils that might cause lesions and virus transmission.…”

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

Sexual transmission of hepatitis C

“…In CHANG'S et al study (1994) 10 of 307 families of HCV-carrier patients, 28% presented anti-HCV positive mates, a higher percentage, compared to children and other household contacts of HCV index case (6.4%) (ρ < 0.001). Anti-HCV positivity was 23% in husbands who presented wives as an index case, and 29% in wives who presented husbands as an index case 10 .…”

“…Anti-HCV positivity was 23% in husbands who presented wives as an index case, and 29% in wives who presented husbands as an index case 10 .…”

“…We also know that the transmission of HBV and HIV is considerably greater than that of HCV; however, the number of people who could acquire Hepatitis C by sexual means should not be neglected 10,15,17,23,24,28,40,51,85,86 .…”