Document 1072
 DOCN  M9471072
 TI    The epidemiology of hepatitis C virus transmission.
 DT    9409
 AU    Osmond DH; Univ. of California, Berkeley
 SO    Diss Abstr Int [B]; 53(10):5160 1993. Unique Identifier : AIDSLINE
       ICDB/94690954
 AB    Hepatitis C virus (HCV) is a newly identified virus that is the most
       important agent of non-A non-B hepatitis and is associated with
       cirrhosis and hepatocellular carcinoma. HCV is readily transmitted
       intravenously by blood and blood products, but preliminary reports have
       disagreed about the importance of perinatal and sexual transmission. In
       170 heterosexual couples, 18% of the women (31/170) and 33% of the men
       (56/170) were HCV seropositive by RIBA-2 immunoblot. Intravenous drug
       use (IVDU) (OR = 27.0, 95% CI = 13.4-56.1, p less than 0.0001),
       hemophilia (OR = infinity, 95% CI = 1.9-infinity, p = 0.01), and history
       of blood transfusion (OR = 2.7, 95% CI = 1.1-7.0, p = 0.02) were
       significantly associated with HCV seropositivity. No associations were
       found for measures of sexual behavior within HCV concordant couples or
       with number of sexual partners, history of sexually transmitted
       diseases, or HIV seropositivity. However, 2/31 females without
       parenteral risk but with an HCV positive male partner were HCV
       seropositive compared with 0/81 females with an HCV negative partner (p
       = 0.07). Thirty-four (4.6%) of 735 homosexual/bisexual men were HCV
       seropositive by RIBA-2 immunoblot compared to 81% who were positive for
       one or more hepatitis B virus (HBV) serological markers. History of IVDU
       (OR = 14.3, 95% CI = 6.4-31.9, p less than 0.0001) and history of blood
       transfusion (OR = 4.7, 95% CI = 1.3-13.8, p = 0.009) were strongly
       associated with HCV seropositivity but neither was significantly
       associated with HBV seropositivity. Sexual behavior variables were
       associated with infection with both viruses. After controlling for IVDU
       and a history of blood transfusion, there were marginal associations of
       HCV with more than 50 sexual partners in a year (OR = 2.4, 95% CI =
       1.1-5.4, p = 0.03) and with more than 25 anal receptive partners (OR =
       2.2, 95% CI = 1.0-5.0, p = 0.05) and stronger associations of HBV with
       the same variables (OR = 2.8, CI = 1.5-5.4, p = 0.001 and OR = 3.2, CI =
       1.5-6.6, p = 0.001, respectively). Together the two studies and a review
       of the HCV literature indicated that intravenous exposure to blood and
       blood products is the primary route of HCV transmission but that HCV is
       transmitted sexually, albeit infrequently. Because there is reason to
       believe that HCV infection tends to become chronic and that a high
       proportion of those positive for HCV antibodies may be infectious, the
       pool of asymptomatic HCV carriers may be large and sexual transmission
       may play a more significant role in spreading HCV than the relative
       inefficiency of its transmission would suggest. (Full text available
       from University Microfilms International, Ann Arbor, MI, as Order No.
       AAD93-05026)
 DE    Female  HIV Seropositivity  Hepatitis C/BLOOD/*EPIDEMIOLOGY/TRANSMISSION
       Homosexuality  Human  Male  Sex Behavior  Sexual Partners  Sexually
       Transmitted Diseases/TRANSMISSION  THESIS

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).