HEPATITIS-C TRANSMISSION ON THE NORTH COAST OF NEW-SOUTH-WALES - EXPLAINING THE UNEXPLAINED

Objective: To determine the routes of hepatitis C virus (HCV) transmis sion in an Australian community. Design: Questionnaire-based, cross-se ctional survey of notified HCV cases. Subjects and setting: All cases notified to the New South Wales North Coast Public Health Unit between 1 January 1993 and 30 September 1994. Outcome measures: Frequency of potential transmission exposures (parenteral and sexual); most likely primary exposure; HCV infection rates in sexual partners and offspring . Results: 467 subjects responded (47% of resident cases). Of these, a ll but one reported actual or potential blood exposures (injecting dru g user [IDU], 85%; IDU with sharing of injection equipment, 76%; pre-1 990 blood transfusions, 6%; other blood exposures, 8%). Most subjects reported multiple exposures and none reported sexual contact as the on ly potential exposure. Of 233 sexual partners tested for HCV, 83 were positive; 54 of these were questioned and all had other parenteral exp osures. Only three children out of 91 children tested were positive fo r HCV (two expressing maternal antibodies). Conclusions: In contrast w ith previous studies, possible HCV transmission modes were identified for almost all respondents. Most respondents in this community were ID Us. Non-parenteral transmission appeared minimal. Novel approaches to preventing HCV transmission in IDUs are needed.