title: Sexual transmission of hepatitis C virus from a patient with chronic disease to his sex partner after removal of an intrauterine device.
abstract: BACKGROUND
  Approximately 40% of patients infected with hepatitis C virus (HCV) have no history of blood transfusion or other high-risk practice. Other causes should be considered.
  
  
  OBJECTIVE
  The goal was to describe sexual transmission of HCV from a chronic carrier to his female partner during unprotected vaginal intercourse after removal of an intrauterine device.
  
  
  METHODS
  A heterosexual woman who was a regular blood donor acquired acute HCV infection from her sex partner, who was chronically infected. The study included an interview and phylogenetic analysis of sequences of virus obtained from the couple.
  
  
  RESULTS
  Risk factors other than vaginal sexual relations with her partner were ruled out. Phylogenetic analysis showed that sequences from the couple clustered together in all trees generated, in comparison with local and GenBank controls.
  
  
  CONCLUSIONS
  The temporal relationship between removal of the intrauterine device and the acute hepatitis suggests that vaginal mucosal damage might have favored transmission of HCV. Barrier precautions should be suggested whenever damage of the vaginal tract has occurred.
authors.affiliation: Liver Unit, Department of Medicine, Recerca Medicina Interna, Area Investigació B, Hospital Universitari Vall d'Hebron, Pg. Vall d'Hebron 119-129, 08035 Barcelona, Spain. jquer@vhebron.net
authors.forename: Josep
authors.initials: J
authors.lastname: Quer
authors.forename: Pedro
authors.initials: P
authors.lastname: Murillo
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Esteban
authors.forename: Maria
authors.initials: M
authors.lastname: Martell
authors.forename: Rafael
authors.initials: R
authors.lastname: Esteban
authors.forename: Jaime
authors.initials: J
authors.lastname: Guardia
mesh_terms: D000328:Adult; D001782:Blood Donors; D002353:Carrier State / Q000821:virology; D018562:Disease Transmission, Infectious; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000635:transmission* / Q000821:virology; D020010:Heterosexuality; D006801:Humans; D007434:Intrauterine Devices; D008297:Male; D008969:Molecular Sequence Data; D010802:Phylogeny; D015229:Sexually Transmitted Diseases, Viral / Q000635:transmission* / Q000821:virology