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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 ...
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 ...
The aims of the present study were to evaluate in a cohort of mothers infected with hepatitis C virus (HCV) the prevalence of HCV infection of their sexual partners, the influence of infection of the partners on perinatal transmission, and whether this influence is mediated by other well known risk factors for perinatal transmission. Forty-nine consecutive mothers infected with HCV who transmitted infection to their offspring and, as a control group, 557 consecutive mothers infected with HCV who did not transmit infection, together with their children and the fathers of the children who were also the sexual partners of the mothers were evaluated. History of intravenous drug use was significantly more frequent in women with partners infected with HCV than in women with partners not infected [115/180 (63.9%) vs. 87/401 (21.7%); relative risk (RR): 6.38, 95% confidence intervals (CI): 4.34-9.39, P < 10(-3)]. HCV infection was more frequent in the partners of mothers who transmitted perinatally HCV [23/49 (46.9%) vs. 174/557 (31.2%); RR: 1.95, 95%CI: 1.08-3.51, P = 0.03]. Multivariate analysis demonstrated that paternal HCV infection is not a risk factor per se for perinatal HCV transmission, but its role is dependent on maternal intravenous drug use [adjusted RR: 1.23 (95%CI: 0.44-3.39, P = 0.6)]. In conclusion, the present study shows that partners of mothers infected with HCV with a history of intravenous drug use were at a higher risk of HCV infection. HCV infection of the father seems to be associated with perinatal transmission but this relationship is dependent on maternal history of intravenous drug use.
In industrialized countries, hepatitis C virus (HCV) is the most common cause of chronic liver disease in children. Perinatal transmission is the leading cause of infection. Perinatal transmission is confined almost always to women with detectable HCV ribonucleic acid (RNA) in the peripheral blood by the polymerase chain reaction but all children born to women with anti-HCV antibodies should be tested for HCV. Some but not all studies found that a high concentration of serum HCV RNA is associated with a higher risk of transmission. Maternal peripheral blood mononuclear cell infection by HCV, membrane rupture of longer than 6 hr before delivery, and procedures exposing the infant to maternal blood infected with HCV during vaginal delivery are associated with an increased risk of transmission. Maternal coinfection with HCV and human immunodeficiency virus, maternal history of intravenous drug use and of HCV infection of the sexual partner of the mother predict the risk of perinatal transmission and are dependent on the peripheral blood mononuclear cell infection by HCV. Delivery by Cesarean section is not recommended in pregnant women infected with HCV. Infected mothers can breast feed safely their infants if the nipples are not damaged. A previous delivery of a child infected perinatally with HCV does not increase the risk of transmission in subsequent pregnancies. Immunogenetic factors and HCV genotypes are not related to HCV perinatal transmission. Despite an increased understanding of the risk factors involved in perinatal transmission of HCV, to date little is known about the transmission mechanisms and timing.
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