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1994-08-09
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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).