Hepatitis C virus: evidence for sexual transmission.
OBJECTIVE
To determined the prevalence of hepatitis C virus infection and associated risk factors in patients attending a genitourinary medicine clinic, as evidence for sexual transmission.


METHODS
Seroprevalence estimated by reactivity in an enzyme immunoassay for antibodies to C100 protein with supplementary testing with a recombinant immunoblot assay and an assay for hepatitis C virus RNA.


METHODS
Outpatient genitourinary medicine clinic in central London.


METHODS
The panel of 1046 serum samples was from 1074 consecutive patients attending the clinic during November and December 1987 and having blood taken for routine testing for syphilis. Before samples were anonymised demographic and risk factor information was extracted from the clinic notes. Samples had already been tested for antibody to HIV-I and antibody to hepatitis B core antigen.


RESULTS
Significantly more homosexual subjects than heterosexual subjects were positive for hepatitis C antibody determined by enzyme immunoassay alone (19/275 (6.9%) v 8/771 (1.0%), odds ratio 7.14, p less than 0.0001) and also when reactive serum samples were also tested by recombinant immunoblot assay (6/270) (2.2%) v 3/770 (0.4%), odds ratio 5.88, p less than 0.02). There were also significant associations in patients positive for hepatitis C antibody with positivity for antibodies to HIV and to hepatitis B core antigen, lifetime number of sexually transmitted diseases (homosexual men only), and age (all groups combined). Most patients whose serum samples contained specific antibodies to hepatitis C virus were viraemic.


CONCLUSIONS
The study provides strong evidence for the sexual transmission of hepatitis C virus. Assays derived from other gene products are desirable to investigate the specificity and sensitivity of the enzyme immunoassay for C100 antibody as a marker of hepatitis C virus infection.
Tedder
R S
RS
Academic Department of Urology, University College, Middlesex School of Medicine, London.
Gilson
R J
RJ
Briggs
M
M
Loveday
C
C
Cameron
C H
CH
Garson
J A
JA
Kelly
G E
GE
Weller
I V
IV
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016174:Hepacivirus / Q000276:immunology / Q000302:isolation & purification*; D006508:Hepatitis Antibodies / Q000032:analysis*; D006526:Hepatitis C / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D018937:Hepatitis C Antibodies; D006801:Humans; D007124:Immunoenzyme Techniques; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis*; D012307:Risk Factors; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology / Q000635:transmission*
D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral; C078224:anti-C100-3