title: Hepatitis C virus: molecular and epidemiological evidence of male-to-female transmission.
abstract: BACKGROUND
  There is general consensus that hepatitis C virus is efficiently transmitted by the parenteral route, whereas data on viral transmission by sexual or non-sexual intrafamilial contact are conflicting.
  
  
  OBJECTIVE
  The aim of this study was to investigate the transmission of hepatitis C virus in nine heterosexual couples.
  
  
  RESULTS
  The mean age of the couples was 43.7 years. When interviewed, all of the women denied the presence of risk factors for acquisition of the infection, whereas the cause of infection in the nine husbands could be attributed to blood transfusions in two of them (22.2%), use of intravenous and inhaled drugs in six (66.7%), acupuncture in one (11.1%), and tattooing in one (11.1%). All men and none of the women reported sexual relations with sex professionals. The mean homology score (Non Structural 5b-hepatitis C virus) was 98.4%. Among the nine couples with matching subtypes, one (11.1%) was infected with subtype 1a, three (33.3%) with subtype 1b, and five (55.5%) with subtype 3a. Shared personal hygiene items showed a much higher correlation with the possible route of transmission and were better supported by the sequence homology data than the other associated risk factors. Three (33.3%) couples shared toothbrushes, seven (77.8%) shared razor blades, eight (88.8%) shared nail clippers, and six (66.7%) shared manicure cutters.
  
  
  CONCLUSIONS
  Sharing of personal hygiene items was a confounding factor in the discussion of sexual hepatitis C virus transmission and the hypothesis of male-to-female transmission was supported in this study.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil. npcavalheiro@uol.com.br
authors.forename: Norma de Paula
authors.initials: Nde P
authors.lastname: Cavalheiro
authors.forename: Abel de
authors.initials: Ad
authors.lastname: La Rosa
authors.forename: Slava
authors.initials: S
authors.lastname: Elagin
authors.forename: Fatima Mitiko
authors.initials: FM
authors.lastname: Tengan
authors.forename: Antonio Alci
authors.initials: AA
authors.lastname: Barone
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D012747:Sexual Partners; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology / Q000635:transmission*; D018454:Spouses / Q000706:statistics & numerical data*
chemical_list: D012367:RNA, Viral