Intrafamilial transmission of hepatitis C virus in patients with hepatitis C and human immunodeficiency virus coinfection.
OBJECTIVE
The aim of this study was to determine whether hepatitis C virus (HCV)/HIV coinfection of index cases increases intrafamilial transmission (sexual and nonsexual contacts) of HCV.


METHODS
We prospectively enrolled 347 subjects, including 87 family members of 53 HCV/HIV-coinfected index cases and 134 family members of 73 HCV-monoinfected index cases, which served as a control group. All index cases and family members were interviewed, and a screening for HCV and HIV using enzyme-linked immunosorbent assays was performed. Positive samples were confirmed by polymerase chain reaction and tested for genotype and HCV RNA viral load. A meta-analysis designed to assess the pooled risk of sexual transmission of HCV among HCV/HIV-coinfected patients was performed.


RESULTS
Anti-HCV was detected in 2.2% of family members of HCV-monoinfected index cases and 2.3% of family members of HCV/HIV-coinfected index cases. Viral load was higher in coinfected index cases (7.2 x 10(6) mEq/ml) compared with HCV alone (1.9 x 10(6) mEq/ml), p = 0.01. HCV genotype concordance was observed in three family members of HCV-monoinfected index cases and in two family members of HCV/HIV-coinfected index cases. The pooled OR of the meta-analysis evaluating HIV as a cofactor of sexual transmission of HCV was 1.54 (95% CI = 0.76-3.12).


CONCLUSIONS
Our data demonstrate a low prevalence of intrafamilial transmission of HCV, independent of the presence of HCV/HIV coinfection. This finding is supported by meta-analysis, which failed to identify HIV as an important cofactor of sexual transmission in HCV/HIV-coinfected patients.
Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0595, USA.
Daniela R
DR
Keiserman
Cristiane T
CT
Both
Angelo A
AA
Mattos
Jose
J
Remiao
Claudio O P
CO
Alexandre
Kenneth E
KE
Sherman
D000328:Adult; D015331:Cohort Studies; D018562:Disease Transmission, Infectious; D005192:Family Health; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000235:genetics / Q000635:transmission*; D006526:Hepatitis C / Q000150:complications* / Q000235:genetics / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D019562:Viral Load