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Researchers in California conducted
a cross-sectional study with 500 heterosexual, sexually active, monogamous
couples in which one partner had chronic hepatitis C virus (HCV) infection. The
researchers recruited these participants between 2000 and 2003. Participants
were required to have been in a monogamous sexual relationship for at least
three years and to be currently sexually active. Injecting drug users and
persons with hepatitis B infection or HIV coinfection were excluded, as were
couples with the HCV-infected partner taking antiviral drugs.
The participants with HCV and their
partners received HCV antibody and viral load tests; participants with HCV also
had genotype analysis, and for couples with concordant genotype infection,
researchers conducted phylogenetic analysis to determine if the infections were
genetically linked. Participants also provided information about sharing
grooming and hygiene equipment. The couples had been together for a median of 15
years and had a median age of 48 years; approximately 75 percent of
participants were white. The persons with HCV and their partners were
interviewed separately about their sexual behavior. Approximately 17 percent of
the couples used condoms in the first year of the relationship; this dropped to
13 percent in the year of the study. Participants also answered questions about
sexual behavior that potentially involved contact with blood, as HCV is
primarily a blood-borne virus.
The estimated incidence of sexual
HCV transmission ranged from 3.6 per 100,000 person years, or 1 transmission
per 380,000 sexual contacts, to a maximum of 7.2 per 100,000 person years, or 1
transmission every 190,000 sexual acts. The researchers concluded that sexual
transmission of HCV among monogamous heterosexual couples is an extremely
infrequent event. Since condom use was infrequent and decreased throughout the
course of the sexual relationship, the low rate of sexual transmission was not
due to use of barrier methods.
The researchers could not pinpoint
any sexual practices linked with increased risk of sexual transmission.
However, couples with whom possible sexual transmission occurred were more
likely to report vaginal sex during menses and anal sex than couples with no
evidence of sexual transmission. They also reported less frequent condom use.
The researchers noted that the outbreaks of sexually transmitted HCV reported
in HIV-positive gay men in a number of countries likely resulted from
“disrupted mucosal integrity” and the effects of HIV coinfection.
The full report, “Sexual
Transmission of Hepatitis C Virus Among Monogamous Heterosexual Couples: The
HCV Partners Study,” was published online in the journal Hepatology (2013;
doi:10.1002/hep.26164).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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