Lack of evidence of sexual transmission of hepatitis C among monogamous couples: results of a 10-year prospective follow-up study.
The risk of sexual transmission of hepatitis C virus (HCV) infection was evaluated among 895 monogamous heterosexual partners of HCV chronically infected individuals in a long-term prospective study, which provided a follow-up period of 8,060 person-years. Seven hundred and seventy-six (86.7%) spouses were followed for 10 yr, corresponding to 7,760 person-years of observation. One hundred and nineteen (13.3%) spouses (69 whose infected partners cleared the virus following treatment and 50 who ended their relationship or were lost at follow-up) contributed an additional 300 person-years. All couples denied practicing anal intercourse or sex during menstruation, as well as condom use. The average weekly rate of sexual intercourse was 1.8. Three HCV infections were observed during follow-up corresponding to an incidence rate of 0.37 per 1,000 person-years. However, the infecting HCV genotype in one spouse (2a) was different from that of the partner (1b), clearly excluding sexual transmission. The remaining two couples had concordant genotypes, but sequence analysis of the NS5b region of the HCV genome, coupled with phylogenetic analysis showed that the corresponding partners carried different viral isolates, again excluding the possibility of intraspousal transmission of HCV. Our data indicate that the risk of sexual transmission of HCV within heterosexual monogamous couples is extremely low or even null. No general recommendations for condom use seem required for individuals in monogamous partnerships with HCV-infected partners.
Vandelli
Carmen
C
Dipartimento di Medicina Interna, Università di Modena e Reggio Emilia, Modena, Italy.
Renzo
Francesco
F
Romanò
Luisa
L
Tisminetzky
Sergio
S
De Palma
Marisa
M
Stroffolini
Tommaso
T
Ventura
Ezio
E
Zanetti
Alessandro
A
D000328:Adult; D017677:Age Distribution; D001483:Base Sequence; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005191:Family Characteristics; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*; D020010:Heterosexuality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D015229:Sexually Transmitted Diseases, Viral / Q000175:diagnosis / Q000453:epidemiology*
D004279:DNA, Viral