HCV TRANSMISSION IN FAMILY MEMBERS OF SUBJECTS WITH HCV RELATED CHRONIC LIVER-DISEASE

To investigate the risk of sexual and intrafamilial transmission of HC V, 220 family members of 76 patients (index cases) with chronic type C viral liver disease were tested for serological markers of HCV. Of th e family members, 129 were offspring, 64 sexual partners, 15 parents a nd 12 siblings of the index cases. Anti-HCV was tested in all the hous ehold contacts; HCV-RNA was tested in antibody positive samples. The s erologic markers of HCV were tested in a control group of 168 family m embers of 81 patients with chronic hepatitis unrelated to HCV. The ove rall prevalence of anti-HCV was 8.2% compared to 0.6% in the control g roup (p < 0.001). Sexual partners were anti-HCV positive more frequent ly than the other contacts (20% vs 2.2%; p < 0.001), without any diffe rence in males or females. No correlation was observed between the occ urrence of HCV infection in contacts and age, severity of liver diseas e or risk factor for the acquisition of HCV in the index cases. Seven of the 18 (39%) anti-HCV positive family contacts had biochemical evid ence of chronic liver disease, histologically confirmed in the 6 patie nts who underwent a liver biopsy. Liver chemistry was normal in all th e HCV-negative contacts. Ten of the 18 anti-HCV positive contacts (55% ) were HCV-RNA positive. Genotypes were the same (Ib) in 4 of the 7 vi remic couples of subjects: in 3 of the 6 couples of sexual partners an d in the only mother/son couple. These data suggest the occurrence of intraspousal transmission of HCV, while intrafamiliar acquisition of H CV in non-sexual contacts seems to be rare.