[Heterosexual transmission of hepatitis-C virus]

Parenteral transmission of hepatitis C virus (HCV) through blood transfusions and intravenous drug misuse is well established. Since 50% of patients with hepatitis C have no history of parenteral exposure, other ways of transmission must exist. The purpose of this study was to examine the epidemiological importance of heterosexual intercourse for transmission of HCV infection. 29 heterosexual contacts (13 men, 16 women, mean age 47 years) of 29 index patients (16 men, 13 women, mean age 49 years) with histologically und serologically documented chronic hepatitis C were questioned about parenteral exposure and sexual behaviour. Their serum samples were examined for ALT activity and anti-HCV antibodies (first-generation Ortho-HCV-ELISA). Five contacts were using condoms to prevent infection. Five of 24 contacts (21%) practising unprotected sexual intercourse, but none of 5 contacts using condoms, showed evidence of heterosexual HCV transmission: 4 were anti-HCV positive (one with elevated ALT activity) and another showed elevated ALT activity with a negative anti-HCV test. None of these contacts had a history of parenteral exposure. Our results indicate that heterosexual transmission of HCV is epidemiologically important. The true rate of infection may be even higher, for two reasons: (1) not every HCV infection is detected by the anti-HCV test, and (2) the anti-HCV test may turn negative again in uncomplicated infection.