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Intrafamilial transmission of hepatitis C virus
1Third Department of Internal Medicine, Kumamoto University School of Medicine, Japan.
Insights
Hepatitis C virus (HCV) intrafamilial transmission is lower than antibody positivity rates suggest. Subtyping revealed fewer shared HCV strains among family members than initial tests indicated.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Hepatitis C virus (HCV) infection can lead to chronic liver disease.
- Understanding intrafamilial transmission is crucial for prevention strategies.
Purpose of the Study:
- To investigate the intrafamilial transmission patterns of Hepatitis C virus (HCV).
- To determine the actual rate of HCV transmission within families of infected individuals.
Main Methods:
- Analyzed anti-HCV antibodies and HCV RNA in 118 family members from 61 index patients.
- Assessed positivity rates across different familial relationships (parents, spouses, children, siblings).
- Utilized HCV subtyping to confirm transmission events.
Main Results:
- Overall positivity rates for anti-HCV and HCV RNA were 12.7% and 11.0%, respectively.
- Positivity varied by relationship, with sibling pairs showing 25% and spouse pairs 15.8-17.6%.
- HCV subtyping indicated a lower transmission rate than antibody/RNA positivity suggested, with only 4/7 pairs sharing identical subtypes.
Conclusions:
- Intrafamilial transmission of HCV is less frequent than indicated by serological and RNA assays alone.
- HCV subtyping is essential for accurately assessing transmission within households.
- Further research may refine understanding of HCV's spread in close contacts.
Abstract:
The intrafamilial transmission pattern of hepatitis C virus (HCV) was examined in 118 family members of 61 index patients with type C chronic liver disease using anti-HCV antibodies and HCV RNA assay. The study subjects consisted of eight parents, 49 spouses, 50 children, eight siblings and three other relatives. The positivity rates of anti-C100, anti-JCC, second-generation anti-HCV and HCV RNA were 6.8, 12.7, 12.7 and 11.0%, respectively. Positivity in one or more anti-HCV antibody assay was detected in 3/24 (12.5%) father-child pairs, 3/17 (17.6%) mother-child pairs, 2/8 (25%) sibling pairs, 6/38 (15.8%) husband-wife pairs and 2/13 (15.4%) wife-husband pairs. In spouses, positivity for anti-HCV antibody or HCV RNA was observed after 40 years of age. None of 11 spouses married < 15 years was positive for any anti-HCV assay or HCV RNA. In spouses whose age was > 50 years and duration of marriage was > 25 years, anti-HCV or HCV RNA was frequently detected (32.0%). However, when seven pairs involving four spouses, one mother-daughter pair and two sibling pairs were subtyped, the same HCV subtypes were found in only four pairs (type II in three pairs and type III in one pair). Further, the agreement rate between anti-HCV and HCV RNA was > 90%. These results suggest that intrafamilial transmission of HCV, revealed by the subtyping method, is considered lower than the percentage of positivity for anti-HCV antibodies or HCV RNA in family members of patients with type C chronic liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)