title: Risk factors for hepatitis C virus seropositivity in heterosexual couples.
abstract: OBJECTIVE
  To determine the risk of heterosexual transmission of hepatitis C virus (HCV) and to identify other risk factors for HCV seropositivity in heterosexual couples.
  
  
  METHODS
  Retrospective cross-sectional study comparing HCV-seropositive and HCV-seronegative heterosexual men and women.
  
  
  METHODS
  Couples recruited from the community and screened for participation in a study of the heterosexual transmission of human immunodeficiency virus.
  
  
  METHODS
  A total of 340 subjects, 170 men and 170 women in sexual partnerships, aged 18 through 61 years.
  
  
  METHODS
  Seropositivity for HCV antibodies.
  
  
  RESULTS
  Overall, 31 (18%) of the 170 women and 56 (33%) of the 170 men were positive by a four-antigen HCV immunoblot. Injection drug use and hemophilia were strongly associated with HCV seropositivity. Sixty-four percent of injection drug users were positive (odds ratio [OR], 27.0; 95% confidence interval [CI], 13.4 to 56.1; P < .0001), as were all four hemophiliacs in the study. History of blood transfusion was significantly associated with HCV seropositivity (OR, 2.7; 95% CI, 1.1 to 7.0; P = .02). Positivity for HCV was not associated with measures of sexual behavior within couples or with numbers of other sexual partners, history of sexually transmitted diseases, or human immunodeficiency virus seropositivity. However, two of the 31 women without parenteral risk but with a long-term HCV-positive male partner were HCV seropositive compared with none of 81 women with an HCV-negative male partner (P = .07).
  
  
  CONCLUSIONS
  These results provide little evidence of HCV sexual transmission but are consistent with infrequent sexual transmission. They corroborate the importance of injection drug use and transfusion of blood or blood products in transmitting HCV and underscore the importance of ascertaining parenteral exposures when examining sexual transmission of HCV.
authors.affiliation: Department of Epidemiology and Biostatics, University of California, San Francisco.
authors.forename: D H
authors.initials: DH
authors.lastname: Osmond
authors.forename: N S
authors.initials: NS
authors.lastname: Padian
authors.forename: H W
authors.initials: HW
authors.lastname: Sheppard
authors.forename: S
authors.initials: S
authors.lastname: Glass
authors.forename: S C
authors.initials: SC
authors.lastname: Shiboski
authors.forename: A
authors.initials: A
authors.lastname: Reingold
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission*; D006801:Humans; D015151:Immunoblotting; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012725:Sexual Behavior; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology*
chemical_list: D006508:Hepatitis Antibodies