Interspousal transmission of hepatitis C in Thailand.
BACKGROUND
Previous studies evaluating the possibility of interspousal sexual transmission of hepatitis C virus (HCV) have yielded many conflicting results. Our study was carried out to determine the exact potential and risk factors of interspousal HCV transmission.


METHODS
The spouses (54 men and 106 women; mean age +/-SD, 48 +/- 8 years) of 160 patients with HCV infection (106 men and 54 women) were serologically tested for HCV using a third-generation enzyme-linked immuno- sorbent assay (ELISA). Positive results were confirmed by reverse transcriptase polymerase chain reaction (RT-PCR). For positive couples, the cluster nucleotides of the HCV gene and genotypes were compared on the basis of restriction fragment length polymorphism (RFLP), Innogenetic Line Probe Assay (INNO-LiPA), and direct sequencing. Similarly, phylogenetic tree and sequence homology analysis was performed in order to precisely verify interspousal transmission. Risk factors promoting interspousal HCV transmission were also identified.


RESULTS
Throughout a mean duration of exposure of 23 + 5 years, most of the 160 partners had their usual and unprotected sexual relationships with the index patients. HCV-associated antibodies and HCV-RNA were detected in only 3 (1.88%) of the 160 spouses. Furthermore, homology and phylogenetic tree analysis could not clearly demonstrate that any one of these 3 positive spouses was infected with the same strain of HCV as that identified in the index cases. Because a positive group remained elusive, risk factors of interspousal HCV transmission could not be determined in this study.


CONCLUSIONS
According to this study, interspousal transmission of HCV seems to be very rare. HCV-positive spouses should be firmly reassured that they can maintain their normal marital life.
Boonyarad
Vorayod
V
Section of Digestive and Liver Diseases, Department of Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.
Chutaputti
Anuchit
A
Choeichareon
Sommai
S
Bedi
Kavita
K
Theamboonlers
Apiradee
A
Chinchai
Teeraporn
T
Poovorawan
Yong
Y
D005192:Family Health; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000235:genetics / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012150:Polymorphism, Restriction Fragment Length; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D018454:Spouses; D013785:Thailand