INTERSPOUSAL AND INTRAFAMILIAL TRANSMISSION OF HEPATITIS-C VIRUS - A MYTH OR A CONCERN

Objective: To investigate intrafamilial and interspousal transmission of hepatitis C virus. Methods: The incidence of anti-hepatitis C virus antibodies in 224 family members of 65 index patients was studied. Si xty-five of the 94 index patients were asymptomatic, apparently health y parturient Egyptian women, who were detected to be anti-hepatitis C virus positive at routine antenatal screening and whose spouses reside d in the United Arab Emirates. The serologic status of family members of seropositive index patients was compared with that of 218 family co ntacts of 65 matched healthy anti-hepatitis C virus-negative parturien t Egyptian women (control group). To determine interspousal transmissi on, hepatitis C virus genotype was determined in 35 of 36 hepatitis C virus-RNA positive index patient-spouse pairs and 22 of 25 nonrelated RNA positive pairs by polymerase chain reaction, Subsequently nucleoti de sequencing of the hepatitis C virus genome was done. Results: In co mparison with the control group, a significantly greater number of fam ily members of the index patients were anti-hepatitis C virus positive (five of 218 versus 60 of 224; P <.004). Husbands of index patients h ad the highest prevalence of anti-hepatitis C virus (74%), with longer duration of marriage being an important risk factor. Of the 35 index patient-spouse pairs analyzed, 33 (94%) had the same hepatitis C virus genotype. On nucleotide sequencing, 30 (91%) couples showed 100% homo logy, and two had a high (>97%) homology. Among nonspouse pairs, six p airs (27%) had the same hepatitis C virus genotype; however, low nucle otide sequence homologies (less than 85%) were noted. Conclusion: Thes e data suggest that interspousal transmission of hepatitis C virus occ urs and that this may be are important route of intrafamilial spread o f hepatitis C virus infection. (C) 1998 by The American College of Obs tetricians and Gynecologists.