Sexual Transmission of Hepatitis C: A Rare Event among Heterosexual Couples

Transmission of hepatitis C virus (HCV) is primarily attributed to percutaneous exposure to infected blood. Methods to prevent percutaneous transmission are well defined and clear counselling messages exist to reduce person-to-person transmission of virus (Centers for Disease Control and Prevention, 1998). While studies suggest that sexual transmission of HCV occurs infrequently, few studies thoroughly investigated sexual risk factors and potential confounding transmission modes within the household (Alter et al., 1989;Tahan et al., 2005; Vandelli et al., 2004; Piazza et al., 1997; Gordon et al., 1992; Osmond et al., 1993). These ambiguities hampered development of clear counselling messages for sexual practices among HCV-infected persons.

To obtain more quantitative information on sexual transmission risk for the most common sexual partnerships among infected persons, the HCV Partners Study studied monogamous, heterosexual couples in long-term relationships (≥36 months), without confounding exposures such as viral coinfection (HIV or HBV) or both partners having a history of injection drug use (Osmond et al., 2013). Among 500 couples and 8377 person-years of sexual contact, the HCV Partners Study found a low prevalence of HCV infection among partners, with a maximum of 1.2% (95% CI: 0.2%–2.2%) of infections potentially attributable to sexual contact. The maximal incidence of HCV infection was 7.2 per 10,000 person-years (95% CI: 1.3–13.0), and maximal risk per sexual contact was 1 per 380,000 (95% CI: 1/600,000–1/280,000). These estimates were similar to or lower than previously reported rates for both prevalences (2.0%–10.3%) (Tahan et al., 2005; Vandelli et al., 2004; Stroffolini et al., 2001) and incidence (0.0–23.3 per 10,000 person-years) (Vandelli et al., 2004;Marincovich et al., 2003; Kao et al., 2000). Overall, available data indicate that HCV transmission by sex is reassuringly low, and the HCV Partners Study provides the numerical context to counsel HCV-infected persons in monogamous partnerships.

Full article at:  http://goo.gl/Ky5gbf

By:  Jennifer L. Dodge and Norah A. Terrault*

University of California–San Francisco, San Francisco, CA, USA

^*Corresponding author. Email: ude.fscu@tluarreT.haroN

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