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Hepatitis C virus infection: other biological fluids than blood may be responsible for intrafamilial spread
A M Mastromatteo1, G L Rapaccini, M Pompili
1Department of Hygiene, Catholic University of Sacred Heart, Largo F.Vito, 1-00168 Rome, Italy.
Insights
Hepatitis C virus (HCV) may spread within families through non-parenteral routes. Some infected relatives are serum-negative but saliva-positive, suggesting biological fluids play a role in HCV transmission.
Area of Science:
- Hepatology
- Virology
- Epidemiology
Background:
- Parenteral transmission is the primary route for Hepatitis C Virus (HCV).
- Alternative transmission routes for HCV are suspected but not fully understood.
- Intrafamilial spread of HCV requires further investigation.
Purpose of the Study:
- To determine the prevalence of HCV infection among family contacts of HCV patients.
- To identify potential risk factors and alternative transmission routes for HCV within families.
- To explore non-parenteral transmission mechanisms of HCV.
Main Methods:
- Studied 138 relatives (spouses, children, cohabitants) of 45 HCV patients.
- Tested for serum anti-HCV antibodies and serum HCV-RNA.
- Analyzed HCV-RNA presence in saliva of index cases and infected relatives.
Main Results:
- HCV antibodies detected in 5.7% of family members.
- 11.1% of spouses were serum HCV-RNA positive.
- HCV-RNA found in 44% of saliva samples; 39% of these individuals were serum-negative.
Conclusions:
- Intrafamilial HCV spread may be underestimated.
- Serum-negative but saliva-positive relatives indicate potential non-parenteral transmission.
- Biological fluids likely contribute to intrafamilial HCV transmission.
Background/Aims:
Several epidemiological studies have shown the existence of other routes of transmission of the hepatitis C virus besides the parenteral one, but the mechanisms involved are not yet understood. The general aim of this study was to evaluate the prevalence of hepatitis C virus infection in family contacts of infected patients and to analyze the possible risk factors and alternative transmission routes.
Methodology:
One hundred and thirty-eight relatives of 45 patients (index cases) affected by C virus-related chronic hepatitis were studied. The relatives were 45 spouses, 89 children and 4 cohabitants who underwent detection of serum anti-HCV antibodies; the anti-HCV-positive subjects were tested for serum HCV-RNA. The index cases, all the spouses and only other infected relatives were tested for the presence of HCV-RNA in saliva
Results:
Antibodies to hepatitis C virus were detected in 5.7% of the family members while 11.1% of the analyzed spouses were serum HCV-RNA-positive. HCV-RNA was found in 44% of the examined saliva and 39% of these were found serum HCV-RNA-negative. The prevalence of hepatitis C virus among household contacts, excluding cases with previous parenteral exposure, was 3.6%.
Conclusions:
The epidemiological data on the intrafamilial spread of hepatitis C virus may be underestimated owing to the existence of infected relatives serum-negative but saliva-positive for the presence of the virus. The whole of these observations suggests a possible role of biological fluids in intrafamilial spread of hepatitis C virus.