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Sexual Transmission of HCV Is Rare in Monogamous Heterosexual Couples CME
News Author: Laurie Barclay, MD
CME Author: Charles Vega, MD, FAAFP
Release Date: May 13, 2004
May 13, 2004 — Sexual transmission of hepatitis C virus (HCV) is rare in monogamous heterosexual couples, according to the results of a 10-year prospective study published in the May issue of the American Journal of Gastroenterology.
"The rate of HCV infection in sexual partners of anti-HCV-positive individuals has been shown to range between very low and as high as 30%," write Carmen Vandelli, MD, from the Universita di Modena e Reggio Emilia in Italy, and colleagues. "These discordant findings may partly be explained by the confounding effect of nonsexual transmission routes."
In a long-term study, 895 monogamous heterosexual partners of individuals chronically infected with HCV were followed for a total of 8,060 person-years. Of these 895 partners, 776 spouses (86.7%) were followed for 10 years, corresponding to 7,760 person-years. An additional 300 person-years were contributed by spouses whose infected partners cleared the virus during treatment, who ended the relationship, or who were lost to follow-up. All of these couples denied practicing anal intercourse, vaginal intercourse during menstruation, or condom use. Average frequency of sexual intercourse was 1.8 times per week.
During follow-up, there were three HCV infections, corresponding to an incidence rate of 0.37 per 1,000 person-years. HCV genotyping, sequence analysis, and phylogenetic analysis suggested that the corresponding partners carried different viral isolates, which would rule out spousal transmission of HCV.
However, the authors note that in 33 (3.4%) of 967 couples initially investigated, both partners were anti-HCV positive, suggesting the possibility that HCV could have been transmitted earlier in their relationship.
"Our data indicate that the risk of sexual transmission of HCV is extremely low or even null," the authors write. "No general recommendations for condom use seem required for individuals in monogamous relationships with HCV-infected partners."
Based on other studies, however, the authors strongly advised these couples to avoid sharing personal hygiene items such as toothbrushes, razors and nail clippers.
The Association for the Study of Infectious and Metabolic Diseases of the Liver supported this study.
Am J Gastroenterol. 2004;99:855-859 |
