A study on the role of the family and other risk factors in HCV transmission

'Background/aims: To understand the intrafamilial transmission and the exis ting risk factors related to HCV infection in subjects confirmed anti-HCV p ositive, their sexual partners and household contacts in Friuli, North-East Italy. Methods: We enrolled all the subjects that were consecutively ident ified as HCV positive during routine laboratory testing in six health distr icts and their household contacts. From each subject we obtained a blood sa mple, demographic data and a medical history including the existence of ris k factors for HCV. Antibodies to HCV were detected employing a commercially available second-generation enzyme immunoassay (EIA); positive serum speci mens were retested using a second-generation recombinant immunoblot assay ( RIBA-2). Results: We recruited 743 subjects, 229 first subjects identified as HCV positive and 514 household contacts. There were no statistically sig nificant differences in positivity among household contacts. Analysing intr acouple transmission we found no significant differences by gender in coupl es both with and without parenteral risk factors. We found, both with univa riate and multivariate analysis, as statistically significant risk factors in all the subjects: age older than 60, blood transfusions (particularly th ose performed before 1984), surgical procedures such as abortion and/or ute rine curettage, history of HBV infection, intravenous drug use, and tattooi ng. Conclusions: Our results stress the low relevance of sexual transmissio n in the intrafamilial context, the importance of abortion and/or uterine c urettage, the important role of blood transfusions in the past, a higher pr evalence of HCV infection within a household of a HCV positive member compa red to all other existing data in the area.