Sexual transmission of hepatitis C virus to a repeat blood donor

Capelli, Carmen; Prati, Daniele; Bosoni, Patrizia; Zanuso, F; Pappalettera, M.; Mozzi, Fulvio; Mattei, Claudia De; Zanella, Alberto; Sirchia, G.

doi:10.1046/j.1537-2995.1997.37497265345.x

Cited by 33 publications

(17 citation statements)

References 20 publications

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“…The similarity of the virus in the couple was 93.4% (E2/NS1 region). No other risk factor was identified 7 .…”

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confidence: 97%

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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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“…The similarity of the virus in the couple was 93.4% (E2/NS1 region). No other risk factor was identified 7 .…”

mentioning

confidence: 97%

“…In a report by CAPELLI et al (1997) 7 a female repeat donor was surprised to learn that she was PCR-HCV positive, sometime between the two donations. She noted that she lived with a sexual partner who was a chronic HCV carrier.…”

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confidence: 99%

Sexual transmission of hepatitis C

Cavalheiro

2007

Rev. Inst. Med. trop. S. Paulo

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“…1,2 The strength of these reports lay in their ability to document seroconversion in an individual at risk in temporal relationship to sexual activity with an HCV-infected partner. The mode of transmission was ascertained by carefully questioning the infected individual to exclude nonsexual sources of HCV.…”

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confidence: 99%

Sexual activity as a risk factor for hepatitis C

Terrault

2002

Hepatology

131

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The accumulated evidence indicates that hepatitis C virus (HCV) can be transmitted by sexual contact but much less efficiently than other sexually transmitted viruses, including hepatitis B virus and human immunodeficiency virus (HIV). However, because sex is such a common behavior and the reservoir of HCV-infected individuals is sizable, sexual transmission of HCV likely contributes to the total burden of infection in the United States. Risk of HCV transmission by sexual contact differs by the type of sexual relationship. Persons in long-term monogamous partnerships are at lower risk of HCV acquisition (0% to 0.6% per year) than persons with multiple partners or those at risk for sexually transmitted diseases (0.4% to 1.8% per year). This difference may reflect differences in sexual risk behaviors or differences in rates of exposure to nonsexual sources of HCV, such as injection drug use or shared razors and toothbrushes. In seroprevalence studies in monogamous, heterosexual partners of HCV-infected, HIV-negative persons, the frequency of antibody-positive and genotype-concordant couples is 2.8% to 11% in Southeast Asia, 0% to 6.3% in Northern Europe, and 2.7% in the United States. Among individuals at risk for sexually transmitted diseases ( P ercutaneous exposures, such as blood transfusion and injection drug use, are well-established risk factors for hepatitis C virus (HCV) infection. The risk of HCV transmission by sexual contact, however, is less well defined. The accumulated epidemiologic evidence indicates that HCV can be transmitted by sexual contact but much less efficiently than other sexuallytransmitted viruses, including hepatitis B virus and human immunodeficiency virus (HIV).There are several case reports of acute hepatitis C occurring in persons whose only risk factor appeared to be a HCV-infected sexual partner. 1,2 The strength of these reports lay in their ability to document seroconversion in an individual at risk in temporal relationship to sexual activity with an HCV-infected partner. The mode of transmission was ascertained by carefully questioning the infected individual to exclude nonsexual sources of HCV. A high degree of sequence homology between the viral strains in the sexual partners provided virological confirmation that a transmission event had occurred.While there is sufficient evidence to support the conclusion that sexual transmission of HCV occurs, quantifying the magnitude of an individual's risk of HCV acquisition by sexual contact is more difficult. Epidemiologic studies have had several methodological shortcomings that tend to overestimate the proportion of HCV infections attributed to sexual contact. Early studies used first-generation antibody to HCV (anti-HCV) assays which have a higher false positive rate than second-and third-generation assays. Studies varied in the completeness of risk ascertainment in partners, and many failed to carefully exclude HCV acquisition from nonsexual sources (Fig. 1). Nondisclosure of injection drug use is particularly important because a...

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“…28 Morsica et al and Capelli et al reported acute infection of only one female patient, with similarities of 94.9% and 93.4%, respectively, with an HCV-positive sexual partner being the only risk factor in the two studies. 7,23 Chayama et al reported similarity ranging from 91.4% to 99.8% in eight cases seen at a hepatology service. 29 Williams and Alter, researchers at the Viral Hepatitis Division of the Centers for Disease Control and Prevention, followed up 263 cases of acute hepatitis C and 13% of these patients reported sexual exposure as the only source of risk for the acquisition of the disease.…”

Section: Virologymentioning

confidence: 98%

“…She admitted a sexual partnership with a man with chronic HCV infection. 23 According to Weisbord et al, having sexual contact with an HCV-positive person was independently associated with being anti-HCV positive. 15 In the case of HCV-positive patients, it is still not possible to clearly distinguish between those who present a potential of sexually transmitting HCV and those who do not.…”

Section: Epidemiologymentioning

confidence: 99%

Hepatitis C virus: molecular and epidemiological evidence of male-to-female transmission

Cavalheiro

Rosa²,

Elagin³

et al. 2010

Braz J Infect Dis

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Introduction:There is general consensus that hepatitis C virus is effi ciently transmitted by the parenteral route, whereas data on viral transmission by sexual or non-sexual intrafamilial contact are confl icting. Objective and Method: The aim of this study was to investigate the transmission of hepatitis C virus in nine heterosexual couples. Result: The mean age of the couples was 43.7 years. When interviewed, all of the women denied the presence of risk factors for acquisition of the infection, whereas the cause of infection in the nine husbands could be attributed to blood transfusions in two of them (22.2%), use of intravenous and inhaled drugs in six (66.7%), acupuncture in one (11.1%), and tattooing in one (11.1%). All men and none of the women reported sexual relations with sex professionals. The mean homology score (Non Structural 5b-hepatitis C virus) was 98.4%. Among the nine couples with matching subtypes, one (11.1%) was infected with subtype 1a, three (33.3%) with subtype 1b, and fi ve (55.5%) with subtype 3a. Shared personal hygiene items showed a much higher correlation with the possible route of transmission and were better supported by the sequence homology data than the other associated risk factors. Three (33.3%) couples shared toothbrushes, seven (77.8%) shared razor blades, eight (88.8%) shared nail clippers, and six (66.7%) shared manicure cutters. Conclusion: Sharing of personal hygiene items was a confounding factor in the discussion of sexual hepatitis C virus transmission and the hypothesis of male-to-female transmission was supported in this study.

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Sexual transmission of hepatitis C virus to a repeat blood donor

Abstract: Heterosexual transmission of HCV can occur in the absence of a long-lasting contact, and the infection can be asymptomatic. It remains to be determined whether the sexual partners of HCV-infected subjects should be deferred from blood donation.

Cited by 33 publications

References 20 publications

Sexual transmission of hepatitis C

Sexual transmission of hepatitis C

Sexual activity as a risk factor for hepatitis C

Hepatitis C virus: molecular and epidemiological evidence of male-to-female transmission

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