Sexual transmission of hepatitis C virus: the Turin study

Background. Hepatitis C virus infection (HCV) is a major cause of chronic l iver disease with the risk of evolution towards hepatic cirrhosis and hepat ocellular carcinoma. Numerous studies have documented the possibility of HC V transmission through blood transfusions during surgery or during intraven ous drug use. The percentage of the risk of sexual transmission, in the gen eral population not presenting the aforesaid risks is still very controvers ial. The aim of this study was to evaluate the concomitant levels of seropo sitivity for anti-HCV, in the partners of patients with chronic HCV liver d isease, but no history of previous transfusions or use of intravenous drugs . Methods. The study included 196 anti-HCV positive spouses with a clinical d iagnosis of active chronic hepatitis, aged between 20 and 75 years (mean ag e 53 years, SD +/- 11 years). HCV infection was diagnosed by positivity of serum samples for anti HCV (EIA), confirmed by RIBA II and by circulating H CV-RNA detected by polymerase chain reaction (PCR). All partners underwent anti-HCV assay (EIA), confirmed by RIBA II in the event of positivity. Results. The mean period of cohabitation was 27 years (range 3-37, SD +/- 9 .8 years). The positivity of anti HCV in both subjects affected 11 couples (5.6%). Of these couples, the viral genotype was also available in 3 cases which proved to be identical in the index patient and the partner, whereas it was not possible to identify the genotype in other couples owing to scar ce compliance. Conclusions. The data obtained from this study confirm the possibility of t he sexual transmission of HCV. However, in the context of subjects not belo nging to "high risk" groups, this method of transmission does not appear to be important if compared with that of other viruses (HBV and HIV).