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.