Risk factors for hepatitis C virus seropositivity in heterosexual couples
D. H. Osmond, N. S. Padian, H. W. Sheppard, S. Glass, S. C. Shiboski and A. Reingold
Department of Epidemiology and Biostatics, University of California, San Francisco.
OBJECTIVES. To determine the risk of heterosexual transmission of hepatitis
C virus (HCV) and to identify other risk factors for HCV seropositivity in
heterosexual couples. DESIGN. Retrospective cross-sectional study comparing
HCV-seropositive and HCV-seronegative heterosexual men and women. SETTING.
Couples recruited from the community and screened for participation in a
study of the heterosexual transmission of human immunodeficiency virus.
PARTICIPANTS. A total of 340 subjects, 170 men and 170 women in sexual
partnerships, aged 18 through 61 years. MAIN OUTCOME MEASURE.
Seropositivity for HCV antibodies. RESULTS. Overall, 31 (18%) of the 170
women and 56 (33%) of the 170 men were positive by a four-antigen HCV
immunoblot. Injection drug use and hemophilia were strongly associated with
HCV seropositivity. Sixty-four percent of injection drug users were
positive (odds ratio [OR], 27.0; 95% confidence interval [CI], 13.4 to
56.1; P < .0001), as were all four hemophiliacs in the study. History of
blood transfusion was significantly associated with HCV seropositivity (OR,
2.7; 95% CI, 1.1 to 7.0; P = .02). Positivity for HCV was not associated
with measures of sexual behavior within couples or with numbers of other
sexual partners, history of sexually transmitted diseases, or human
immunodeficiency virus seropositivity. However, two of the 31 women without
parenteral risk but with a long-term HCV-positive male partner were HCV
seropositive compared with none of 81 women with an HCV-negative male
partner (P = .07). CONCLUSIONS. These results provide little evidence of
HCV sexual transmission but are consistent with infrequent sexual
transmission. They corroborate the importance of injection drug use and
transfusion of blood or blood products in transmitting HCV and underscore
the importance of ascertaining parenteral exposures when examining sexual
transmission of HCV.
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